New resource to Support High-Quality Perinatal Mental Health Care

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:

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

Read MMHA's news story on the launch of these resources

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.”

Download Supporting High-Quality Perinatal Mental Health Care Resource

Download Evidence Review - Supporting High-Quality Perinatal Mental Health Care: What does good look like?

Celebrating iHV’s achievements in family mental health and looking ahead

Just before the end of 2022, the iHV celebrated its 10^th 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.”

Download iHV Mental Health Report 2022/23

Health visiting on BBC Radio 4’s World at One today!

Alison Morton, Executive Director iHV, joined Jonny Dymond on BBC Radio 4’s World at One today to discuss the surge in new mothers and pregnant women seeking help for mental health problems in the lockdown.

The piece on perinatal mental health and health visiting begins with a mum, Amy, sharing her PMH concerns as a new mother and how it impacted her life during the pandemic – this starts at 32:18 into the programme. Alison joins at 35:53 to talk about the health visiting service and the role that health visitors play in providing support to new mothers. Jonny asked if the figures on perinatal mental illness that Radio 4 World at One have become aware of reflect what health visitors are seeing. Alison shared that before the pandemic 20-25% of women and some men had perinatal mental health needs and that the pandemic has made the situation much worse, with rates reportedly doubling. Alison speaks about the vital role that health visitors play supporting families and the difference that getting support early can make.

Alison also shares the challenges that the health visiting service in England faces. In particular, she shares how the needs of women and babies have been largely overlooked in the pandemic response and the impact that this has had on families. With widespread recognition that many women do not find it easy to speak out about how they are feeling, and against a backdrop of 31% cuts to the health visiting workforce since 2015, Alison highlights how these cuts reduce the amount of time that HVs can spend with families. She commented that health visitors come into the profession wanting to support babies and families – to give babies the best start in life! When challenged about whether families have been let down, Alison agrees that the sector has been under enormous pressure, but defended the profession by saying, “I can tell you categorically that health visitors did the very best job they could under immensely challenging circumstances!”

Listen to BBC Radio 4 World at One - 30 July 2021

Recording available for 29 days only from 30 July
PMH piece starts at 32:18
Alison Morton starts at 35:53
Piece ends 39:19

Rescheduled Date for PMH & Fathers Champion Training – BOOK NOW!

This training has been rescheduled from Thursday 29 April to Tuesday 22 June.

We are delighted this event on Tuesday 22 June 2021 will be co-delivered by Kieran Anders – Project Manager of Dad Matters and a nationally respected voice in this important area of mental health.

Our Multi-Agency Perinatal Mental Health & Fathers Champion Training Programme is designed to improve family mental health by:

increasing competence and confidence in perinatal mental health practice, working with a whole family-inclusive approach
developing place-based leadership for fathers/partners mental health issues in the perinatal period
raising awareness of the significance of fathers/partners wellbeing for the whole family with the workforce

The new online delivery format models our highly acclaimed face-to-face programme for PIMH and will equip Champions with the necessary understanding, knowledge and competence to lead on fathers’ perinatal mental health in their local areas.

New Date: Tuesday 22 June 2021, 9:00am – 4:15pm

£225 – iHV Member (membership number required for booking)
£250 – Non-member

For more details and how to apply

Bookings open for Multi-Agency Fathers and PMH Champions training!

We’re delighted to share that bookings for our Multi-Agency Fathers and Perinatal Mental Health Champions training taking place on 29 April are open.

Our Multi-Agency Fathers & PMH Champions training programme is designed to improve family mental health by:

increasing competence and confidence in perinatal mental health practice, working with a whole family inclusive approach
developing place-based leadership for fathers / partners mental health issues in the perinatal period
raising awareness of the significance of fathers / partners wellbeing for the whole family with the workforce

We are delighted this event on 29 April will be co-delivered by Kieran Anders – Project Manager of Dad Matters and a nationally respected voice in this important area of mental health.

Date: 29 April 2021, 09:00-16:15

£225 – iHV Member (membership number required for booking)
£250 – Non-member

For more details and how to apply

iHV Mental Health Lead nominated for UKIMS Presidency

iHV is delighted to announce that our Mental Health Lead, Melita Walker, has been nominated for, and accepted, the role of President of the United Kingdom and Ireland Marcé Society (UKIMS).

Melita Walker, iHV Mental Health Lead

The International Marcé Society for Perinatal Mental Health is an international, interdisciplinary organisation dedicated to supporting research and assistance surrounding prenatal and postpartum mental health for mothers, fathers /partners and their babies. The iHV has been a longstanding supporter of the International Marcé Society and the regional branch. The overall mission and aims of the Society are strongly aligned to the charitable objectives of the Institute of Health Visiting and the work of the iHV, its 5 pillars and the workstreams progressed as part of the iHV Mental Health Department.

In accepting the position, Melita Walker said:

“I am deeply honoured to have been nominated to lead the UK and Ireland regional group of such a world-leading and well-renowned perinatal mental health community. I look forward to being able to strengthen the contribution of health visiting within the international perinatal community and vice-versa, strengthening the Society by spotlighting: a whole systems approach to perinatal and infant mental health; thinking of the whole family; transferring knowledge into practice; public mental health and prevention; informing research from practice and practice from research; and co-production with parents/families.”

Melita will serve one year as President-elect, at the end of this term she will become President of UKIMS and serve for 3 years.

Melita continued:

“The Marcé Society has been a source of inspiration to me and the connections we have made. These connections and the fabulous International and regional UKIMS meetings have enabled us at the iHV to make sure that our training, resources, responses to policy consultations and events are informed by the very latest cutting-edge research.

“I am particularly excited that my term as President will coincide with Professor Louise Howard’s term as President of the International Society and am very much looking forward to seeing lots of health visitors at the Biennial International Marcé Meeting in London in 2022!”

NSPCC – Many new parents may be ‘suffering in silence’ during lockdown

On Maternal Mental Health Awareness Day (6 May), the NSPCC highlights rising concern that many new parents may be ‘suffering in silence’ during lockdown.

The Institute was pleased to support an NSPCC virtual roundtable looking at the effects of the COVID-19 crisis on new mothers’ mental health, and the risk of potential long-term consequences on babies’ health and development. The panel said their services had adapted to support parents digitally, but they shared concerns about the effect of the COVID-19 crisis on mothers and babies.

The NSPCC reported an increase of 28% in calls to its helpline about parental mental health in the first three weeks of lockdown.

Before the pandemic, up to one in five mothers and one in 10 fathers experienced perinatal mental health problems, the charity said.

Eileen O’Sullivan, a specialist health visitor in Warwickshire, said:

“Supporting mothers digitally can be challenging and there is a concern that some may be suffering in silence, too scared to share how they are really feeling over video.

“I am also seeing that my colleagues are being extra vigilant because we don’t want to miss anything.”

The NSPCC cited data from the Institute of Health Visiting, which found in some areas of England at least 50% of health visitors, including some from perinatal mental health and parent-infant teams, were redeployed into other health services in the initial period of the lockdown.

The NSPCC is urging the Government to ensure support is provided to parents as the country comes out of lockdown, and to come up with a plan to rebuild health visiting and perinatal services after the crisis.

Andrew Fellowes, public affairs manager at the NSPCC, said:

“At the NSPCC we know that, if undetected and untreated, perinatal mental health problems can have a devastating impact on women, partners and babies, both immediately but also long after the COVID-19 situation has passed.

“It is imperative that families continue to have access to services during the lockdown so that mental health problems can be identified and specialist support provided if needed.”

The iHV continues to support health visitors, our perinatal mental health champions and specialist health visitors in perinatal and infant mental health to deliver their services to families who may be adversely affected by the lockdown, particularly with respect to safeguarding and mental health issues. We have produced specific guidance to help which can be found in our COVID-19 (coronavirus) guidance for health professionals webpage: https://iHV.org.uk/COVID-19

Let’s hear it for Family Perinatal Mental Health

At the start of the UK Maternal Mental Health Awareness Week (4-10 May 2020) with the theme of ‘Supporting mums during difficult times’, a blog by Melita Walker, Mental Health Lead at the Institute of Health Visiting , to highlight the essential work of health visitors in supporting mums’ and families’ mental health needs – and a call to join us in recognising and appreciating all Mental Health Practitioners as key frontline workers at 8pm this Thursday #ClapForMentalHealthHeroes @ClapforCarers @ClapForKeyworkers.

iHV clapping our Mental Health Workers

This Thursday at 8pm, like the previous Thursdays, the Institute of Health Visiting will be joining the national wave of appreciation for our courageous frontline workers. However, this week as part of Maternal Mental Health Week, we particularly want to recognise and honour the determined efforts of the iHV Perinatal and Infant Mental Health Champions and all those who have been working tirelessly alongside them throughout this pandemic, to prioritise and ensure that the mental health needs of families are effectively and proactively responded to during this pandemic.

The perinatal period, whilst often being one of great joy, is also an increased time of risk and vulnerability. Latest UK research suggests that:

1 in 4 women are affected by perinatal mental health disorders
Maternal suicide is the leading cause of death when looked at over the perinatal period
Approximately 10% fathers experience perinatal mental illness (PMI) but 25-50% of fathers will experience perinatal anxiety or depression when the mother also has a PMI

The impact on the foetus or the infant/child who has a parent experiencing mental illness is not inevitably negative, but they are at increased risk for a range of poorer outcomes and it is essential that we make sure their voice is heard and that we are proactive and act to support families at the earliest opportunity.

At the moment, parents are having to negotiate the usual associated changes that becoming a parent involves (physiological, psychological, environmental, social and emotional changes) alongside reduced family, friend and service support and other increased worries, stress and impact caused by the COVID-19 pandemic.

“How it feels to be 29 weeks pregnant amid COVID-19, a thread…Truly I have no idea how I am supposed to feel. At first, I was really calm and over the last few days everything has changed. I am scared, I am anxious”.

As the country faces its biggest challenge in recent memory, the primary focus has been to stop the spread of the coronavirus and treat infected patients. This has required a rapid increase in staff required for frontline duties and, understandably, this is a priority. Attention is now turning to the secondary impacts of the pandemic, including the mental health and wellbeing of our children and their families. They too are at immediate risk and they cannot wait for support.

As this pandemic is global in its reach, learning from previous pandemics and other countries’ current experiences of the secondary impact of COVID-19 suggest that the pandemic is likely to have more adverse effects for vulnerable parents and children, with domestic violence and abuse, safeguarding and mental health needs of vulnerable populations likely to increase as the crisis continues. It is therefore imperative that the national response to COVID-19 incorporates both the immediate focus to treat people who are infected with the coronavirus, as well as children and families at risk from the secondary impact of the pandemic. We ignore, at our peril, the impact of not seeing perinatal and infant mental health (PIMH) practitioners as frontline workers in the fight against COVID-19.

The iHV has trained 2095 multi-agency PIMH Champions and we are hearing the voices from professionals across the range of PIMH systems and services and from parents with needs across the mental health spectrum of care. Parents are telling us that they are anxious – we know for some that the current situation is triggering new episodes of illness and for others exacerbating illness already there, and we are hearing that parents feel unsure about reaching out for support.

Eve Canavan BEM, Coordinator- UK maternal mental health awareness week, Perinatal Mental Health Partnership, commented:

“The Perinatal Mental Health Partnership have received feedback from mums and families of the uncertainty surrounding what support is available from health care professionals at this unusual time, with a clear message coming through that those who require support are unsure if they can contact their GP, midwife, health visitor or local mental health services. This means some women may not be currently accessing support they need. The stigma surrounding mental health and the perception that services are so overstretched and unsafe means that many mums are struggling but do not feel they have the right to ask for the help that they need. We are delighted to be working with the iHV and other key stakeholders during Maternal Mental Health week to get the message out that family mental health is a priority and that services to support families are very much open for business”.

We are hearing from professionals whose concerns include, worry about:

hidden and unmet need
risk of suicide
the immediate safety of women and their unborn babies/infants/children
the potential impact of untreated mental health problems/illness on the unborn baby, developing infant and older children
the impact of the current stress that families are experiencing on the couple relationship/ couple conflict and domestic violence and abuse.

“Its really important to consider the impact of changes in working practices and redeployment of staff who play a vital role in in assessment, monitoring and onward referral for mums mental health. Some perinatal mental health conditions develop rapidly and without warning and families need urgent help”.

We are hearing that some PIMH practitioners have been redeployed while at the same time we are hearing that parents and their children need them now, and more than ever. We are also hearing of practitioners and services that continue to see the vital importance of prioritising mental health and from parents who say that they are a lifeline.

“I am pleased to say XXX health visiting service is increasing. 34 staff are being redeployed back in from various services within the trust. Health Visiting in XXX is considered critical to life service at the moment”.

“Now reassuring pregnant and postnatal mums, some of whom are fearful of attending hospital for maternity care. Please continue to keep antenatal appointments, scans and sharing worries and concerns with your midwife, it is safe to do so. If something doesn’t feel right, call you midwife”.

“Met my HV over the phone today- so knowledgeable, professional and kind!! Thankful for such a simple adjustment to practice that is reassuring for newbie mums”.

What can we do to support perinatal and infant mental health at this time?

The iHV will do all we can to support our PIMH Champions and colleagues working across the PIMH spectrum. We will continue to collaborate nationally, to support all families locally.

We have developed a comprehensive compendium of resources for professionals and families:

iHV Parenting through COVID-19 resources: https://iHV.org.uk/ParentingCOVID19
iHV COVID-19 professional resources: https://iHV.org.uk/COVID-19
iHV Mental Health website: https://bit.ly/2xz7wwe
PATH project – Parenting through COVID-19: https://bit.ly/33WW21M

We are regularly updating these pages, so please keep checking back for the latest!

Let’s hear it for Family Perinatal Mental Health – this Thursday!

Maternal Mental Health , with its theme of “how to support mums through difficult times”, is a great opportunity to raise the importance of family mental health and to let families know what support is out there. It was brilliant to have the profile of perinatal mental health raised by the Duchess of Cambridge over weekend, and it has been wonderful to work alongside so many individuals, organisations, professionals, parents and alliances to highlight the need for supporting family mental health.

We look forward to sharing more of the fantastic examples of the responses and efforts from our frontline mental health practitioners to support family mental health during Maternal Mental Health week. Mental health practitioners are frontline now, and crucially, will be needed on the frontline (dealing with the psychological aftermath of COVID-19), long after any vaccine has brought the coronairus under control.

We do hope you will join us in recognising and appreciating all Mental Health Practitioners as key frontline workers at 8pm this Thursday #ClapForMentalHealthHeroes @ClapforCarers @ClapForKeyworkers

Melita Walker, Mental Health Lead at the Institute of Health Visiting

New publication – iHV COVID-19 professional advice: Family Perinatal Mental Health

We are delighted to publish the latest addition to our new series of iHV COVID-19 professional advice – Family Perinatal Mental Health.

Developed in partnership with Public Health England by the professional team at the Institute of Health Visiting, the series of documents support the safe and effective delivery of health visiting practice during the global pandemic.

Download iHV COVID-19 Professional advice: Family Perinatal Mental Health

The new iHV COVID-19 professional advice: Family Perinatal Mental Health joins our suite of documents Delivering the Health Visitor Healthy Child Programme during the COVID-19 pandemic – Professional advice to support best practice which includes:

Please note: As the COVID-19 situation is rapidly changing, the information in these resources may change. Please keep checking the Government and NHS websites for details.

Also, don’t forget our COVID-19 webpages for health visitors and parents – see details below:

COVID-19 webpages

For Health Visitors– These new professional advice documents can be found on our COVID-19 (coronavirus) guidance for health visitors webpage – https://iHV.org.uk/COVID-19
For parents and families– The iHV is dedicated to supporting the health and wellbeing of all families and we are putting together links and resources from trusted organisations and websites to support parents and families during the COVID-19 pandemic – please see our Parenting through Coronavirus (COVID-19) webpage – https://iHV.org.uk/ParentingCOVID19

We have waivered our usual restrictions on resources for members and the COVID-19 sections of our website are “free access” to all to support the national response to this pandemic.

iHV proud to support launch of Perinatal Peer Support Principles

As an active member of the Maternal Mental Health Alliance (MMHA), the iHV is proud to have supported the new perinatal peer support principles – launched on 3 December.

Launch of Perinatal Peer Support Principles at Peerfest on 3 December 2019

The Perinatal Peer Support Principles are a set of five values designed to give peer supporters the confidence to create and deliver peer support that meets the needs of women and families affected by mental health problems during pregnancy or the postnatal period.

The principles were co-designed by Mind, the McPin Foundation, and a team of lived experience facilitators, with support from the MMHA. They provide guidance to help ensure that peer support is safe, inclusive, and helpful, and that it meets the unique needs of mothers and babies.

Laura Wood, a mum with lived experience and one of three lived experience facilitators on this project, said:

“I hope that these principles will make safe, welcoming, nurturing peer support accessible to more mums who need it. I believe that they will, as lived experience has been at the heart of the project. Because the principles were co-created with women and families who have lived through perinatal mental health difficulties, they are shaped around their needs, not what others imagine those needs to be.”

You can access the principles, and a more detailed report, via the Maternal Mental Health Alliance website.

Read Laura's blog on what they did to develop the principles

To subscribe to the newsletter and/or enquire about hosting a workshop or event with the perinatal peer support principles, please email [email protected]