17th June 2013
Sally Hogg, author of the new NSPCC report “Prevention in Mind” writes about the report and the important part that health visitors play in helping mothers at risk of, or suffering from perinatal mental health illnesses.
At least 1 in 10 women experience a mental illness during pregnancy or after the birth of their babies in England each year. These women do not suffer alone; their illness can also impact on their families, particularly their babies. This is why the NSPCC is calling for better prevention, detection and treatment of perinatal mental illnesses.
Perinatal mental illnesses range from anxiety and depression to postnatal psychotic disorders. Many people have heard about postnatal depression, but serious perinatal mental illnesses are far less well recognised. These disorders may be rare, but are not as uncommon as the lack of knowledge about them might suggest – postpartum psychosis is twice as prevalent as Down’s Syndrome – something new parents are very aware of.
What can be done?
We believe there must be a change in the approach of health services if we are to achieve better prevention of perinatal mental illnesses, and early intervention when they occur. The mental health of mums and babies must be given the same importance as their physical health.
Health visitors can play a key part in ensuring that mums who are at risk or suffering from mental illness are identified and get the right support when they need it. However our research with new mums says that this doesn’t always happen.
We believe the system needs to change to enable hard working and dedicated midwives and health visitors to give mothers the care they need. ‘Prevention in Mind’ calls for more to be done to ensure that professionals get training and support to talk about perinatal mental health problems and the time to discuss these issues sensitively with women. Importantly, it also argues that there must be specialist services in place to refer women to if problems are detected.
There are of course health visitors already doing excellent work in this area. Last year, I spent time shadowing a fantastic health visitor in Herefordshire who visited vulnerable mums, including those with a history of severe mental illness, during their pregnancy. She used promotional interviewing techniques, as recommended by the Healthy Child Programme, to find out about these mums’ emotional wellbeing and the support they needed. There are other examples of great practice out there – we need to ensure every mother gets this level of care.
We strongly believe that there should be perinatal mental health care pathways in every area, with a range of support on offer – including social support, therapy, and specialist mental health provision – so that every woman can access help appropriate to her needs. ‘Prevention in Mind’ contains evidence to show that this support simply doesn’t exist in many places: For example, less than half of mental health trusts have specialist perinatal mental health services in place. There are also shortages in specialist Mother and Baby Units, which means that women with severe mental illness can go without the intensive expert care that they need and are separated from their babies, which can disrupt vital early bonding.
Fast and effective action on perinatal mental illness is critical for babies’ outcomes. As every health visitor knows, babies’ early experiences set the foundations for their later development. Therefore it is important that mothers with mental illnesses get help to interact in a positive and sensitive way with their babies. Specialist perinatal mental health services can support the mother-infant relationship, something that general adult mental health services may not have the time, resources or expertise to do.
What next?
On Tuesday 18 June, Health Minister Dan Poulter is holding a round table meeting with key commissioning and professional bodies that can make a difference to the support available for families affected by perinatal mental illnesses. This meeting provides a valuable opportunity for all to discuss what action can be taken to ensure these families get the help they need, as soon as possible. Every baby is entitled to the best start in life, and to achieve this, we must ensure their mothers have the support that they need.
