Mental health problems during pregnancy or after giving birth are common. There can be poor long-term outcomes for parents and families without timely access to effective support and treatment. The Maternal Mental Health Alliance (MMHA) has today, launched a briefing to support Integrated Care Systems (ICSs) in England to make the most of their unique position, to ensure that all families who need support for their mental health in the perinatal period get the right level of help, at the right time, close to home.

Integrated care boards and partnerships have a statutory role in population health management. They bring together the NHS, local government, public services and civil society organisations, to explore how to improve health, reduce health inequalities and use public money wisely in the local context. Addressing mental health and wellbeing needs in the perinatal period provides ICSs with a unique opportunity to take a systemic approach in establishing good building blocks for health, for future generations.

The MMHA commissioned the Centre for Mental Health to produce a briefing to support ICSs to consider how best support can be offered. This builds on earlier work co-produced by the Institute of Health Visiting (iHV) and The MMHA to guide system’s thinking on perinatal mental health and how best practice can be further embedded (read our previous news story on this here).

The briefing encourages proactive leadership within the ICS system to ensure effective support for groups of women whose needs are less well met by existing services, including those from racialised communities, asylum seekers and refugees, single mothers, young mothers, those living in poverty or experiencing domestic abuse, LGBTQ+ parents, neurodiverse and disabled people, those who are care-experienced and those experiencing multiple adversities such as addiction, homelessness and exploitation.

Key areas for action are identified including, for universal services, the recommendation for midwives, GPs, and health visitors to ask about a woman’s mental health at all routine antenatal and postnatal appointments, as per national guidelines. Previous evidence supporting integrated mental health care with maternity and health visiting services, as both clinically effective and cost-effective, is highlighted. This proposed integrated service provision model would offer the following key support elements:

  • Screening: Asking every woman in a skilled way about their mental health to identify need
  • Assessment: Assessing the severity of women’s mental health needs and planning the most appropriate treatment in partnership with the individual
  • Treatment: Offering low-intensity treatments for common mental health problems
  • Coordination: Ensuring women receive ‘joined-up’ care and subsequent care and support as needed.

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

“This important briefing highlights the unique opportunities that Integrated Care Boards and partnerships have to develop the universal workforce. When health visiting, maternity and GP services are adequately trained and resourced, families can be offered early, effective tailored support that can prevent problems developing or worsening.”

Further actions are included specific to NHS talking therapies, Specialist Perinatal Mental Health Services, Inpatient Services and Voluntary and Community Sector Support.

The briefing will be shared with all ICSs and we encourage you to draw attention to the publication through your local contacts and communications.

 

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) is delighted to announce that its Perinatal and Infant Mental Health (PIMH) Champions Programme has been shortlisted for the Workforce Initiative of the Year at the HSJ Awards 2021, recognising their outstanding contribution to healthcare – in what has been an exceptional and challenging period across the sector.

HSJ Awards 2021 Finalist banner

Despite the demanding circumstances of the past 18 months, over 1000 entries have been received for this year’s HSJ Awards. The volume and standards of applications has been a true testament to those health and social care staff, who continue to push outstanding work and transformational projects across the sector.

Melita Walker, Head of the Mental Health Department at The Institute of Health Visiting, commented:

“We are delighted to have been shortlisted for the HSJ Workforce Initiative of the Year. With such stiff competition and eminent judges, it is a massive honour for the Institute to be shortlisted. This significant recognition really does reflect the collaborative efforts and dedication of #TeamiHV and the iHV PIMH Champions.

“The iHV PIMH Champions programme has evolved over several years (alongside the evidence base, changing policy and evolving national standards) and is unique in its capacity to reach large audiences through our highly developed leadership-cascade model which builds in sustainability for commissioners. The programme and its quality assurance measures have been co-designed, co-developed and co-delivered alongside experts by experience as well as perinatal mental health experts from the professions we commonly train, i.e. health visitors, midwives, obstetricians, general practitioners and psychiatrists and other mental health workers.”

The judging panel comprised a diverse range of highly influential and respected figures within the healthcare community, including: Sir Bruce Keogh (Chair, Birmingham Women’s and Children’s FT); Marie Gabriel CBE (Chair, NHS Race and Health Observatory); and former HSJ Trust of the Year winners Ann Marr OBE (Chief Executive, St Helens and Knowsley Teaching Hospitals Trust) and Richard Mitchell (Chief Executive, Sherwood Forest Hospitals FT).

Following the intense and in-depth judging process the iHV was shortlisted, ahead of the official awards ceremony to be held later this year (18 November). Standing out amongst tough competition from hundreds of other exemplary applicants, the iHV Perinatal and Infant Mental Health Champions Programme was selected based on ambition, visionary spirit and the demonstrable positive impact that the project has had for professionals and families.

The COVID-19 pandemic necessitated significant changes to the way in which healthcare practitioners were able to access training and professional development. The Institute of Health Visiting was well-positioned and responsive in adapting their highly renowned Perinatal and Infant Mental Health (PIMH) Champions’ Programmes to meet the requirements of the virtual world. In doing so, they enabled ongoing access to standardised, high-quality national training and support, ensuring that frontline PIMH practitioners were sufficiently equipped and skilled to meet the increasing needs of families and improve outcomes for those affected by, or at risk of, perinatal and infant mental health problems.

HSJ editor Alistair McLellan, commented:

“On behalf of all my colleagues, I’d like to take this opportunity to congratulate the Institute of Health Visiting on being nominated in the category of Workforce Initiative of the Year in this year’s HSJ Awards. The applications we receive always present our panel of judges with a very difficult task as the standard is unfailingly high and the breadth of innovation and passion for patient care is always so inspiring.

“This year, we really have been overwhelmed with the level of entries, particularly when set against the backdrop of the COVID-19 pandemic and the huge challenges faced by our health and social care workforce.

“We are therefore looking forward to welcoming all our finalists to the live ceremony in November and joining us in celebrating their incredible achievements and commitment to excellence.”

The full list of nominees for the HSJ Awards 2021 can be found on https://awards.hsj.co.uk/shortlist-2021.

The selected winners will be announced during the awards ceremony at Evolution, London, on 18 November 2021.

New training date: 10 and 11 July 2019

Location: London

Following previous sell out events, we are offering a further rare opportunity to access a place to train as a Multi-Agency iHV Champion for Perinatal & Infant Mental Health via our highly acclaimed integrated programme.

The programme is an accredited 2 day course which will cover a wide and updated programme content supported by contemporaneous evidence and policy underpinning practice.

This training has been specifically designed to support an onward cascade across a multi-agency audience to ensure that all staff working alongside mothers and their families perinatally can access awareness training.

The Institute of Health Visiting (iHV) has published its response to the consultation – Mental Health in the Long-Term Plan for the NHS.

The consultation is to identify opportunities to deliver the NHS’s goal to provide world-class mental healthcare – improving the outcomes for everyone who uses the NHS services.

Dr Cheryll Adams CBE, Executive Director, Institute of Health Visiting said:

“At the Institute, we firmly believe there is no health without mental health, which is why we have perinatal and infant mental health (PIMH) as a priority focus. We welcome the opportunity to respond to this consultation to ensure that all families get consistent, accessible, high quality care and support for their mental health during the perinatal period. Our response reflects the many consultations and surveys we have done with our members and other stakeholders over the recent months and years.”

The Institute’s response includes its top three priorities in mental health:

  • Resourcing health visiting services through joint commissioning which formally requires health visitors to take a specific lead for perinatal and infant mental health;
  • Closing the gap between knowledge of what affects child and family mental health, and how services are commissioned and organised to implement this knowledge;
  • A need to concentrate efforts to create a much wider understanding of the epidemiology of mental illness with so much of it having its origins in the very first years of life.

Dr Adams continued:

“Early intervention for families in the perinatal period will reduce the burden of mental illness across the life-course! We have to get that message over to politicians and policy makers, so that funding is allocated upstream and not disproportionately spent on secondary and tertiary care, fixing problems that could have been prevented from occurring in the first place.

“This submission focuses on how, with the right support from the NHS and partner organisations, health visitors can ensure that all families with children receive the right care and support for their mental health, at the right time, in the right place.”

 

Further to the story on the limited NHS support for Perinatal Mental Illness published by the Guardian today, which lays bare the poor quality of community services for new mothers, iHV reinforces those concerns and advises that today’s situation is likely to have deteriorated significantly since the audit was completed. The leaked report was compiled in Spring 2017 and uses data from 2016.

Dr Cheryll Adams CBE, Executive Director, iHV, said:

“The Institute of Health Visiting warns that the real state of health visiting support for mothers suffering with perinatal mental illness may be significantly worse than that found by the NHS Benchmarking  report 14 months ago, as there have been further cuts to the workforce and the development of a significant postcode lottery of service up and down the country.

“Health visitors across the country continue to strive to deliver an excellent service to children and families, and will do everything in their power to support mothers they find are affected. The challenge they face is that many no longer deliver a universal service after their 6-8 week contact, when depression and other mental illness may not yet have manifested itself.”

From the annual iHV State of Health Visiting survey 2017 (November 2017 and 1413 respondents), 51% reported cuts to HV posts, 16% reported cuts to their skill-mix team, 12% were awaiting news of the scale of expected cuts, or reported frozen posts and students not employed, only 22% said there had been no cuts where they worked.

In addition from the 2017 survey, 15% are always able to offer listening visits to mothers identified as experiencing postnatal depression, with 36% offering them mostly and 27% some of the time. This is worse than in 2015, when 27% were able to offer listening visits all of the time.

The 2017 survey results indicate that health visitors are increasingly focused on the most vulnerable children and families at the expense of the five mandated reviews, and that the Healthy Child Programme is being implemented in an increasingly ‘targeted’ manner, against its fundamental design principles of full access to it being the right of every baby born in England. The result is that HVs cannot be confident that they are identifying needs or providing early primary prevention. 60% state their ability to make a difference is hampered by ‘Focusing only on those most at risk [that] dilutes universal service’; rather, they are managing risk with children and families with known needs.

Multi-Agency Perinatal & Infant Mental Health Champions Training for individualsBookings open now!

Limited places available – so don’t miss out!

Following previous sell-out at our PIMH training events, we are offering a further rare opportunity to access a place to train as a Multi-Agency iHV Champion for Perinatal & Infant Mental Health via our highly acclaimed integrated programme.

  • Sheffield – 24 and 25 October 2018
  • London – 7 and 8 November 2018.

Duration of course: 2 days

Costs: £395 iHV Members/ £425 Non-members.

The programme is an accredited 2-day course which will cover a wide and updated programme content supported by contemporaneous evidence and policy underpinning practice. You will be supplied with a copy of the new combined Perinatal & Infant Mental Health Champions trainer pack and accompanying resources in order to be able to cascade a one day training to your colleagues to raise awareness of perinatal and infant mental health across your organisation or service.

These courses are very popular – so book your place today!  Don’t miss out!

If you would like more information, please contact [email protected]

The Institute of Health Visiting (iHV) is working with the South West Perinatal and Infant Mental Health Network, with funding from Health Education England in the South West, to deliver Perinatal and Infant Mental Health (PIMH) Champions training across the region.

This training is consistent with the national ambition to achieve safer maternity care, with an emphasis on the importance of multi-disciplinary training for those who work with women during the perinatal period and the aim of achieving parity of esteem between mental and physical health.

Nominations required for new Perinatal and Infant Mental Health Champions training in the South West

We are looking for organisations in the South West to nominate staff to train as Perinatal and Infant Mental Health Champions. Once trained, the Champions will cascade the training to other staff to help ensure safer care during the perinatal period by raising awareness and early identification of perinatal mental health issues and increasing the knowledge and skills of staff. The effectiveness of the cascaded training programme will be assessed by the iHV, which will in turn be shared with participating organisations.

Groups of multi-agency colleagues will attend a 2 day training course at one of the following locations:

Date Venue
5 & 6 January 2017 –  09.00-17.00 Holiday Inn – Plymouth, Devon, PL1 2HJ
9 & 10 February 2017 –  09.00-17.00 Holiday Inn – Filton, Bristol, BS16 1QX
9 & 10 March 2017 –  09.00-17.00 Holiday Inn – Taunton, Somerset, TA1 2UA

The following groups of non-medical professionals are welcome to participate in this training:

  • Midwives
  • Maternity Care Assistants
  • A&E nurses
  • Pharmacists
  • Health visitors

Perinatal and Infant Mental Health Champions are required to:

  • Attend a 2 day training course in January, February or March 2017
  • Attend follow up support for their development as a Champion in the form of face-to-face action learning sets led by the iHV (dates to be confirmed)
  • Deliver one day awareness training sessions within 6 months of their initial training to colleagues

Nomination is by submission of the Expression of Interest Form.

Please note that training places are limited, therefore we ask that you complete and return the Expression of Interest Form by Thursday 1 December 2016 to Kelle Dunn, South West Clinical Network Administrator, [email protected].

Or contact Kelle Dunn, South West Clinical Network Administrator, [email protected].

The Institute of Health Visiting warmly welcomes the new commissioning and workforce development guidance on Specialist Health Visitors in Perinatal and Infant Mental health (PIMH) – What they do and why they matter, published today by Health Education England (HEE).  It concludes that all women and their partners should have access to a specialist health visitor in perinatal and infant mental health (PIMH) and recommends at least one for every health visiting service.

Creating Specialist Health Visitor posts in PIMH within every health visiting service will play a valuable part in reducing the incidence and impact of postnatal depression and other perinatal mental health problems. This will be through earlier diagnosis, better intervention and support – creating savings on child and adult mental health services, and improved public health.

Dr Cheryll Adams, Executive Director of the Institute of Health Visiting (iHV), said:

“The iHV is delighted to endorse this new guidance which provides a framework for improvements in the services that health visitors can provide to families to promote their mental health.

“Through the health visiting ‘universal’ service, health visitors are well-placed to identify those families requiring additional support, especially where the mother (or indeed father) may be suffering from perinatal mental illness, or where the bond between parent and baby may be compromised. However, health visitors have many other roles and responsibilities taking their time during this important period of every child’s life and they would benefit from specialist support in this challenging arena.”

The framework sets out the important role of specialist health visitors in PIMH, illustrates the value to parents and other health professionals involved in a mother’s care and recommends that every woman should have access to a specialist Health Visitor as part of the multi-disciplinary team.