Are you or someone you know, a parent who has experienced mental health problems while you were pregnant or after having your baby, such as depression, anxiety, OCD, or psychosis? Would you be willing to share your story with professionals who work with families during the perinatal period?

We are currently looking for lived experience speakers to join our training events; specifically parents from Black, Black Mixed, Asian or other minoritised ethnic groups; parents from the LGBTQI+ community; and teenage parents.

The iHV Mental Health Team is committed to improving the wellbeing of all babies, children, and their families. Training healthcare professionals across the UK, including midwives, health visitors and psychologists, and early years practitioners, is a fundamental part of this work. Our training programmes have won national and international awards, and we believe the main reason for their success is keeping the voice of the family at the heart. Parents are involved at every step, and our lived experience speakers are one of the most highly valued parts of our training.

A key focus of our work is tackling inequalities in mental health and developing inclusive practice – so that all families are provided with safe, personalised, high-quality care. We need your voice so that our training is truly representative of the diverse communities that we work alongside.

For more information and to find out how to be involved email [email protected].

The mental health of babies and young children is important for their wellbeing now, and critical for their future health and development. These earliest years are a time of rapid development and offer the best chance to lay strong foundations for good mental health. Many people, however, do not really know what being mentally healthy means, especially for babies and young children.

The iHV is delighted to support today’s launch of UNICEF UK and The University of Cambridge Play in Education, Development & Learning (PEDAL) Centre’s new resource ‘Understanding and supporting mental health in infancy and early childhood -a toolkit to support local action in the UK’ that aims to promote a shared understanding of what is meant by mental health in the early years.

Hilda Beauchamp, Perinatal and Infant Mental Health Lead at iHV, said:

“We have been privileged to collaborate with UNICEF UK and PEDAL to produce this important toolkit, highlighting what can be done to support babies’ and young children’s mental health and wellbeing. Health visitors have a vital role to play in ensuring that all babies grow up being mentally healthy: able to understand and manage their emotions, experience nurturing relationships and be able to explore, play and learn.

“This toolkit will help to ensure a more effective whole system approach for health visitors to work alongside their multi-agency colleagues in developing a shared understanding of babies’ and young children’s mental health and see the contributions they can make. Supporting multi-sector working, along with addressing inequalities that affect families, can help to give babies and young children the best start in life.”

The toolkit aims to:

  • Help partners from different services and professions to develop a deeper, shared understanding of mental health in infancy and early childhood, and the factors that influence it
  • Support service leaders, commissioners and other decision makers and policy teams to develop whole-system responses to ensure babies and young children are mentally healthy now and are supported to develop the skills they need to continue to be mentally healthy throughout their lives
  • Provide resources, signposting, and conversation guides to support constructive local discussions, decisions and action about the needs of babies and young children in their area, and what more might be done to respond to these needs (including through strategy development across mental health, maternity, early years or Family Hubs and Start for Life).

iHV and the Maternal Mental Health Alliance (MMHA) are proud to share a new resource and accompanying evidence to support high-quality Perinatal Mental Health (PMH) Care.

The Institute has worked closely with the MMHA for many years to bring about positive change for the mental health and wellbeing of families and there have been huge strides made, but there is still some way to go:

  • At least 1 in 5 women experience a PMH problem, making mental illness the most common serious health problem that a woman might experience in the perinatal period.
  • Suicide is still the leading cause of death for women when looking across the perinatal period.
  • The 2022 MBRRACE report again highlighted gaps in mortality rates between women from deprived and affluent areas, women of different ages, and women from different ethnic groups.
  • Evidence continues to show that people, who identify as LGBTQI+, experience prejudice and discrimination generally and within healthcare services which can lead to worse physical and mental health in the perinatal period.

This latest project brought us together to think about how we can support developing PMH systems across all four nations. The changing landscape of how care is accessed and delivered offers an opportunity for systems to come together to support inclusive high quality family mental health care and this is what led to the latest collaboration between the iHV and MMHA.  It has led to the iHV undertaking an evidence review, which we feel will be incredibly useful for families, practitioners and services.

The Evidence Review, conducted by the iHV, is is a comprehensive desktop review that brings together key publications, policy guidance, toolkits, research, and reports of families’ and practitioners’ lived experiences. The focus of the review is “what does high-quality perinatal mental health care look like?” for women, birthing people and their families. Key themes and principles emerging from the evidence review are captured in the related resource:

Supporting High-Quality Perinatal Mental Health Care is the new resource drawn from the Evidence Review. It provides a strengths-based action template to enable and inform high-quality care for families impacted by PMH problems – enabling individuals to come together and plan “what good looks like” for them, as practitioners, services, professions, organisations, pathways, networks, and systems. This new resource highlights:

  1. Why improving PMH care is crucial
  2. What good care looks like to both practitioners and families with lived experience
  3. 10 principles of best practice

Karen Middleton, Head of Campaigns and Policy, MMHA, says:

“The iHV’s literature review has been incredibly helpful to understand the wealth of information out there on maternal mental health and what action is still needed to ensure high-quality care is available to all who need it. During the review, several recurring themes quickly emerged as well as clear opportunities for learning across the system, as highlighted in the final resource.

“In recent years, there has been a welcome increase in the understanding of the impact of maternal mental health problems. However, many still face huge barriers to accessing essential care. I hope this work will encourage local systems to have collaborative conversations and help them continue to develop services that provide high-quality maternal mental health support for women and birthing people, babies, and families across the UK.”

 Melita Graham, Head of Mental Health, iHV, says:

“Family mental health and wellbeing is complex and, whilst individuals, different professions and services can, and do, make a huge difference – we know that by joining the junctions and pulling together we can achieve so much more. Working closely with the Alliance I have seen the power of collective effort and the positive differences this has made. This latest project aims to support all parts of the PMH system to come together, to think together and to act together – we know that when people with a common interest come together, great things can happen!

“The Institute is committed to promoting family mental health and wellbeing, addressing inequalities and driving change. Alongside the MMHA and other partners, we won’t stop until every family, has access to high quality mental health care in the perinatal period. We very much hope that these new resources will enable high quality perinatal mental care irrespective of where a family may live in the UK.”

Just before the end of 2022, the iHV celebrated its 10th birthday and, reflecting on those years, we feel incredibly privileged to have worked alongside so many inspiring people. Year on year, the iHV Mental Health Team has been part of some phenomenal partnerships, delivering a difference for families – and this last year is no exception. Thank you to you all.

Our Mental Health Team report, published today, looks back and celebrates what we have collectively achieved from January 2022 to January 2023 – despite the challenges. We hope you enjoy it – and we hope that during 2023, as part of enabling your own wellbeing and future successes, you also take the time to celebrate your achievements.

Reflecting on the last 10 years, Melita Graham, iHV Head of Mental Health Dept, said:

I came into the iHV because I believed it was the organisation that would offer me the most opportunity to make the biggest difference, in my lifetime, to the lives of babies and their families. After 10 years, my conviction is even stronger, and without exception, each member of the iHV Mental Health Team shares this belief.

Such a lot has happened in the world in the last year and with the pivot to online working, beside the increased need of mental health support for families because of the pandemic, the cost-of-living crisis and widening inequalities, the professional pace of life is staggering.

Throughout 2022, we have stayed close to health visitors and iHV Champions on the ground, parents with lived experience and our partner organisations. We know how tough it is for families and for health visitors and our partners across the mental health system supporting families. The iHV Survey 2022 makes for sobering reading and the 2022 MBRRACE report yet again showed that suicide is still the leading cause of death for women when looking across the perinatal period. Both reports add weight to the mounting evidence of the unacceptable and preventable widening inequalities across the UK.

The iHV has worked hard alongside you in 2022 to drive change and, going into 2023, we are deeply committed to making sure that the voices of babies and their families are heard. Alongside our partners, we won’t stop until every family, irrespective of where they live, has access to a health visitor who has the right qualities, competence, and capacity to deliver high-quality, personalised, and compassionate family mental health care.

To achieve this, we must make self-care for ourselves and each other a priority. All too often, we move on to the next thing without stopping to acknowledge and consider the challenges overcome, the distance travelled, the differences we have made, and what we need to sustain our energy and our hope for the future. At our final iHV Perinatal and Infant Mental Health Forum in December 2022, iHV PIMH Champions came together and celebrated what they had achieved – despite the challenges. Each one of us went away feeling more supported, buoyed, re-energised and inspired! We are all looking forward to building our connections in 2023 and beyond.

Alison Morton, Executive Director iHV, said:

“I am delighted to see today’s report published which sets out the phenomenal achievements of the iHV’s Mental Health team in the last 12 months. Supporting families’ mental health  is a priority for the Institute and for the nation – we are privileged to have such a highly skilled team leading this work. Congratulations to each member of the iHV’s mental health team for their achievements and Melita Graham for her inspiring leadership.

“I hope that you will enjoy reading today’s report which showcases the numerous award-winning and innovative PIMH programmes that are being delivered across the UK by the iHV, and in partnership with others, to support practitioners in their work with families and better mental health across the lifecourse.”

The Institute of Health Visiting (iHV) publishes the findings from the largest UK survey of frontline health visitors working with families across the United Kingdom.

Our survey findings paint a bleak picture with health visitors seeing first-hand the realities that families with babies and young children in the UK are facing. Health visitors are reporting epidemic levels of poverty, with more parents struggling under the weight of the cost-of-living crisis that is forcing them to turn to food banks to feed their children.  Alongside this, more parents are living with mental health problems, domestic abuse and adversity, that pose risks to the health and wellbeing of babies and young children.

Health visitors are witnessing the impacts of stress associated with poverty on children’s safety, health and development. At the same time, there are insufficient health visitors to meet the scale of rising need. This is being felt most acutely in England, as health visitors are battling to deliver a service following a loss of almost 40% of health visitors since 2015.  Consequently, despite health visitors’ best efforts, many families are not receiving the support that they need, and this is being intensified by a lack of capacity in other health and social care services who are also experiencing extreme pressures.

Alison Morton, Executive Director at the Institute of Health Visiting, says,

“Through their universal reach, health visitors have a privileged and unique view into the lives of babies, young children and their parents/ carers across the UK. Health visitors’ experiences presented in this report provide an important ‘early warning signal’ of the most pressing threats and challenges to the health and wellbeing of our youngest citizens which are often hidden behind front doors and invisible to other services.

“The findings also paint a deteriorating picture of a health visiting workforce under immense pressure as practitioners struggle to meet the scale of rising need. Families are facing the brunt of these challenges with a widening postcode lottery of health visiting support across the UK.”

We publish at a time of ongoing uncertainty with political and economic instability, and ever-increasing health inequalities that will get worse if not addressed. The whole of the health and care system is also struggling to rebuild in the wake of the pandemic. As health visitors often work alone, or in small teams in families’ homes, their work is often hidden and it’s easy to overlook how important it is. The NHS backlogs regularly hit the headlines, but they are only one part of the legacy left by the pandemic on the healthcare system; less high-profile backlogs of care and unmet need in health visiting services have been overlooked within a ‘baby blind spot’ in national policy which will leave equally serious challenges for both mental and physical health for babies, children and families across the UK, now and in years to come.

Alison concludes:

“Because the first years of life are so important for lifelong health, wellbeing and success, ignoring this tsunami of unmet need being experienced by our youngest citizens risks undermining the life chances of so many children.

“It is not too late to change direction and pursue reforms, but the situation is serious. There is now unequivocal evidence that the current rate of health visitor workforce attrition, and insufficient training places to plug the forecasted gaps, is not sustainable and will jeopardise the delivery of all UK Governments’ child health programmes.

“In England, the Government categorised health visiting as one of six priority services in its Start for Life Vision for the first 1001 days. However, this commitment is at risk without investment and a plan to rebuild the health visitor workforce.”

Rising needs and widening inequalities – child safety, health and development: the problem, some key facts and stats:

  • 91% of health visitors reported an increase in poverty affecting families over the past 12 months
  • 91% reported an increase in families needing foodbanks
  • 83% reported an increase in perinatal mental illness
  • 75% reported an increase in domestic abuse.

Health visitors have witnessed first-hand the impact on babies and young children’s safety, health and development:

  • 84% of health visitors reported an increase in children with speech, language and communication delay
  • 76% an increase in child behaviour problems
  • 60% of health visitors reported further increases in child safeguarding over the last 12 months (building on significant increases reported last year).

Health visitors in England also raised serious concerns that national data mask increases in child safeguarding, as:

  • Children living with significant risk and vulnerability are not detected as services are cut, and
  • Social workers’ caseloads are capped to a maximum – growing numbers of children living with significant risk and vulnerability now fall below higher thresholds.

Only 7% of health visitors in the UK felt confident that all families would be able to access the support they needed when a problem was identified. 86% reported that there was not enough capacity in other services to pick up referrals for support/ treatment

Our main policy recommendations:

  1. Prioritise the first 1001 days of life – a shared cross-government ambition and strategy for the first 1001 days is needed to improve health outcomes and reduce inequalities for babies, young children and families. This needs to be prioritised by the Treasury and seen as the smartest of all investments in our nation’s future, rather than as a cost.
  2. A shift towards prevention and early intervention is needed to support all people to lead healthy and fulfilling lives by addressing the key public health priorities that pose the greatest threats to our nation’s health, thereby preventing debilitating and costly ill health in later life.
  3. Equity of access to support is needed for all babies, children and families across the UK and an end to the current postcode lottery.
  4. System’s thinking – the benefits of an effective health visiting service accrue to numerous government departments and across a person’s lifetime. Complex system’s principles need to be applied across all aspects of health and care delivery, including workforce planning, funding and the development of measures that capture health visitor’s input and impact across the system.
  5. Integrated clinical care pathways with significant ‘front-loaded’ investment in prevention and early intervention are needed across health visiting, school nursing, midwifery, social care, General Practice, and early years, to ensure:
  • All babies, children and families are supported to reduce inequalities in key priority areas
  • All children at risk of poor outcomes are identified early
  • A continuum of support for a continuum of need is provided to achieve shared goals for key public health priorities for babies, children and families.
  1. Strengthening the health visiting service requires a clear plan focused on the following three areas:
  • Funding – All areas need sufficient funding to deliver the full national specification for the health visiting service and preventative public health programme for children
  • Workforce – A demand-driven, well-resourced national workforce strategy is needed to increase the number of health visitors to address current and forecasted losses, and improve retention, job satisfaction and career progression for experienced staff
  • Quality – National government must do more to:
    • support local authorities with resources to provide health visiting services at a level that delivers everything that government and NICE guidance expects of them, and that families need
    • hold local authorities to account when services are not meeting national guidelines
    • support the ongoing research, development and sharing of evidence-driven models of best practice based on proportionate universalism.

The Institute of Health Visiting (iHV), working together with parents and Solent NHS Trust, is delighted to share a short film to highlight the value and breadth of the role of the health visitor in relation to family mental health and wellbeing outcomes.

Produced as part of the Interreg 2Seas PATH project*, the film raises the profile of the universal UK health visiting programme, where every family has access to a highly skilled and well-trained health visitor. It showcases the unique opportunity and skills that health visitors have to build relationships and the support that health visitors can offer where additional concerns about parental mental health or the parent-infant relationship are identified.

Created to appeal to parents, health and social care practitioners, government policymakers and commissioners, the film offers insights into a ‘day in the life’ of a UK health visitor, demonstrating the impact of open, trusting relationships and highlighting the importance of continuity of health visitor in building a sense of partnership with parents and families.

Melita Graham, Head of Mental Health at the Institute of Health Visiting, said:

“Supporting the emotional and social, as well as the physical health and wellbeing of the whole family during the perinatal period is a priority for all UK health visitors. We hope that this film will raise awareness of the potential that health visiting has for improving every family’s health and wellbeing.

“We would like to express our sincere gratitude to Whalebone Films, Solent NHS Trust and particularly the parents and families involved in supporting the creation of this film.”

Claire Robinson, Clinical Director for Child and Family Services, Solent NHS Trust, said:

“We are so pleased to be involved in this film which importantly showcases the breadth of skill and knowledge that our health visitors like Sema use every day, in a personalised way for parents and families in our communities. We are really proud of the profound and positive impact that health visitors make in supporting parents and their children in a variety of ways including physical health, early attachment and development, mental health and wellbeing, and practical aspects of parenting, whilst creating meaningful relationships that are so important to both our service and service users.”

 

The film is relevant for health visitors across the UK, and you can use it to promote the work that you do – so please do use and share it.

 

* PATH – PerinAtal menTal Health – is part of the Interreg VA 2Seas programme funded by the European Regional Development Fund. The iHV is one of several partner organisations from across the UK, the Netherlands, France, and Belgium working together to enable women, families, and healthcare professionals to prevent, recognise and successfully manage mild and moderate perinatal mental illness.

PATH seeks to promote positive parenting experiences and empower parents to feel confident in accessing self-help, professional support and guidance from employers, leading to happier and healthier families. Find out more about PATH: https://path-perinatal.eu/uk/ 

Every baby, every child, happy, healthy, safe and valued
and every parent feeling supported and able to achieve this

The core mission at the iHV is to improve the lives of all infants and their families through leading excellence in practice and reducing health inequalities. To help achieve this the Institute has always had a strong focus on perinatal and infant mental health (PIMH). We really do believe that there is “No Health without Mental Health” and that a healthy parent and a healthy parent-infant relationship is the foundation for good mental health across the life-course and, in turn, a healthy society.

 

That said, family mental health and wellbeing is complex and, whilst individuals, different professions and services can and do make a huge difference, we know that by joining the junctions and pulling together we can achieve so much more.

 

Certainly, the successes of the iHV Mental Health Department across 2021 have only been possible through working well with each other and our wider partners and so, on a day that has become known for celebrating relationships, we are delighted to share the iHV Mental Health Department Report 2021/2022.

Alison Morton, Executive Director iHV, said:

“I am delighted to see today’s report published which sets out the phenomenal achievements of the iHV’s Mental Health team in the last 12 months. Supporting better perinatal and infant mental health (PIMH) is a priority for the Institute and for the nation – we are privileged to have such a highly skilled team leading this work. Congratulations to each member of the iHV PIMH team for their achievements and Melita Walker for her inspiring leadership.

“I hope that you will enjoy reading today’s report which showcases the numerous award-winning and innovative PIMH programmes that are being delivered across the UK by the iHV, and in partnership with others, to support practitioners in their work with families and better mental health across the lifecourse.”

Melita Walker, Head of Mental Health iHV, commented:

“I would like to thank the amazing team at the iHV and all our parent, professional and wider system partners. We could not have achieved the successes we have without their fantastic efforts and support. By collaborating and finding ways of keeping connected, even while working remotely, we have enjoyed discovering new talents and perspectives, been able to tackle new projects, opened up possibilities for new solutions and better results, and strengthened the opportunities to enable good family mental health and wellbeing.”

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Happy reading – and THANK YOU
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Exciting and unique development opportunity with the Institute

Professional Development Officer: Perinatal and Infant Mental Health

The iHV is seeking to appoint a Perinatal and Infant Mental Health (PIMH), Professional Development Officer.
The successful post holder will be a health visitor expert in perinatal and infant mental health and will support the iHV Mental Health Department workstream.

The post holder will be home based but, as restrictions ease, they should be prepared to travel mostly within the UK, but potentially also internationally. They will ideally be an iHV PIMH Champion and/or a specialist health visitor for PIMH, have broad experience in these fields, with additional research, or project development experience. A proven track record in delivering high quality PIMH training, both virtually and face-to-face, is essential.

A confident self-starter, they will deliver training to multi-agency audiences, attend national and regional PIMH meetings, deliver UK-wide regional Forums for our PIMH Champions and input advice to other iHV work streams on request.

We are looking for a dynamic and motivated leader, who is passionate about perinatal and infant mental health – an individual who is confident to drive and deliver positive change to enable good family mental health and wellbeing.

This post is for one year in the first instance with a definite expectation of extension, a job share would be considered. The Institute offers a competitive pension scheme.

Applications close: 9am Monday 28 February 2022

iHV welcomes new Maternal Mental Health Alliance (MMHA) economic research report which shows that health visiting has a clinically effective and cost-effective role in perinatal mental health care: The economic case for increasing access to treatment for women with common mental health problems during the perinatal period.

 

  • Independent research commissioned by the Maternal Mental Health Alliance (MMHA), conducted by the London School of Economics and Political Science (LSE), estimates the costs and benefits of addressing unmet maternal mental health needs.
  • The report presents the clear economic benefits from training midwives and health visitors in perinatal mental health and enabling their work with pregnant and postnatal women.
  • Changes to standard practice could have a net economic benefit of £490 million over ten years; £52 million in NHS savings and quality of life improvements worth £437 million
  • Universal services such as health visiting and midwifery have a clinically effective and cost-effective role in perinatal mental health care, identifying women in need or at risk, and facilitating access to or providing treatment as part of their routine work with women during and after pregnancy.
  • The report recommends scaling-up integrated provision across the UK as both desirable and viable from an economic perspective.

In a new study commissioned by the MMHA, researchers from LSE evaluated the economic viability of reforming current treatment for pregnant and postnatal women experiencing common maternal mental health problems such as depression and anxiety.

The report, ‘The economic case for increasing access to treatment for women with common mental health problems during the perinatal period’, estimates the costs and benefits of a model of care which could give women’s mental health the same priority as their physical health. The model, which focuses on the essential role of midwives and health visitors, would allow for women’s mental wellbeing to be accurately assessed at every routine contact and suitable treatments to be offered.

The proposed ‘integrated model of care’ would include dedicated maternal mental health training for health visitors and midwives as well as greater collaboration with other healthcare services.

In the report, resources needed to set up and provide this model of care – namely employment and training costs – are measured against their economic return. Researchers conclude that it could lead to cost savings of £52 million for the NHS over 10 years, and improvements in women’s quality of life estimated at £437 million. In total, this is a net benefit of £490 million over 10 years.

Policy analysis by MMHA member, Centre for Mental Health, determines that equitable integrated service provision is the logical and economical next step in the evolution of perinatal mental health care in the UK. It would close a major gap and ensure women get timely access to help for their mental health needs.

Alison Morton, Executive Director iHV, said:

“Even before COVID-19, there were many system challenges to ensuring that all families had access to the right care and treatment, at the right time, for their mental health and wellbeing. Against a backdrop of rising levels of unmet need, we now need to do better. I am therefore delighted to see this robust and long-awaited research published today – it  presents a sound economic case for health visiting, as an  evidence-based solution to some of these challenges, with a fully costed model of care which demonstrates significant savings alongside improving the lives of families experiencing perinatal mental health problems.

“This report is a significant resource for policy makers looking to deliver the Government’s Start for Life commitment to improve parents’ access to perinatal mental health support and give every child  the best start in life. With such clear evidence, it is vital that the Government acts now to strengthen the health visiting service in England as part of an effective integrated system of perinatal mental health support for families.”

Melita Walker, Head of Mental Health iHV, added:

“Mental health problems in the perinatal period are common and as all families have a health visitor, they are ideally placed to offer skilled, professional support quickly when it’s needed. However, current shortages of health visitors make that difficult, and many families are missing out on effective early help for common mental health problems.

“This new report demonstrates that health visiting has a clinically effective and cost-effective role in perinatal mental health care, identifying families at risk of or suffering from mental health problems and facilitating access to, or providing, effective evidence-based treatments as part of their routine work with women and their families during the perinatal period.

“Ensuring all health visitors have the training and time to meet women’s mental health needs is a sound investment that would make a difference to many thousands of women and their families. Furthermore, this timely new economic evidence strengthens the findings and recommendations highlighted in the latest research by Professor Jane Barlow, on the unique leadership role of Specialist Health Visitor in Perinatal and Infant Mental Health in supporting effective integrated PIMH services.”

If we are serious about using sound evidence to make the biggest difference, then going forward we need to:

  1. Build back our health visitor numbers
  2. Ensure all health visitors have appropriate capacity and high-quality training in family mental health
  3. Have a Specialist PIMH Health Visitor supporting families in every Local Authority in England, every Health Board in Wales and Scotland and every Health and Social Care Trust in Northern Ireland.

 

Oxford University study recommends commissioning of Specialist Health Visitors in Perinatal and Infant Mental Health throughout UK to tackle growing social cost issue

Oxford University has published research examining the training and qualifications of Specialist Health Visitors in Perinatal and Infant Mental Health (Sp HV PIMH), and their role in supporting health visitors and families at risk of /or experiencing mental health problems during the perinatal period.

 

The report recommends that Sp HV PIMH should be commissioned throughout the UK to tackle this issue, which has an extremely high social and financial cost. Currently, Sp HV PIMH constitute just 0.8% of the health visiting workforce (in England). The Oxford research found that in some areas Sp HV PIMH posts had never been funded, and in other areas the funding had been discontinued or cut – these were cited as the biggest barriers to the promotion of perinatal and infant mental health.

Perinatal mental health issues can have a devastating impact on women and their families, and results in a financial cost of £8.1 billion for each one-year cohort of births in the UK, with 72% of this cost relating to adverse impacts on the child. As such, maternal and family mental health has been designated as one of six high-impact areas for the health visiting workforce.

Abigail Reynolds, a mum with lived experience, shared:

“I was diagnosed with severe Anorexia Nervosa in early 2019, when I was seven months pregnant with my second child. The past three years have been unimaginably challenging, but my health visitor​s support throughout my illness and recovery has enabled me to rebuild my life, to learn how to care for myself as well as my children – and to believe I am worthy of that care – and to gain the confidence to begin using my personal experience to help educate and support others in both the eating disorders and perinatal mental health areas.

“Health visitors are so well placed ​within the community, and have a unique opportunity to build trusting relationships with the whole family to support family mental health​ – they are a vital part of the system.”

The study surveyed 41 Sp HV PIMH and 3 Perinatal and Infant Mental Health Champions, who described their casework as focusing on areas such as parental antenatal depression, antenatal anxiety, general anxiety, birth trauma, postnatal depression and panic attacks, using a range of interventions including listening visits and motivational interviewing amongst others.

Survey respondents reported current barriers to the promotion of PIMH as being a lack of funding (82.3%) and a lack of understanding among commissioners about PIMH (64.7%) and the role of HVs in PIMH (73.5%) – with the discontinuity in funding that has occurred over recent years being perceived to have led to a constant need to reinvent the wheel.

Melita Walker, Head of Mental Health at the Institute of Health Visiting, said:

“We welcome this timely report which clearly sets out the important role of Specialist PIMH Health Visitors. Health visitors have a key role in supporting good family mental health. However, even before the Covid-19 pandemic, there were many system challenges to ensuring that all families had access to the right care at the right time. So this year, more than ever, the time has been absolutely right to have a focus on leadership – the role of the  Specialist Health Visitor in Perinatal and Infant Mental Health and how a well-resourced health visiting service, as part of the PIMH system, can maximise the opportunity for good family mental health and wellbeing.

“The timing of this report fits very well with priorities for family mental health and the Government’s recent commitment for PIMH in the last budget. Its recommendations echo what national think tanks, such as the Maternal Mental Health Alliance and the First 1001 Days Movement, are campaigning for and provides policy makers and commissioners with sound evidence to improve family mental health through an effective health visiting service.”