On Thursday last week (19 July), there was a debate on perinatal mental illness in Parliament. It was so encouraging to hear MPs and ministers talking about health visitors.

In an extract from the debate, Dr Paul Williams MP said:

Perhaps a little less well known is the dramatic fall in the number of health visitors. Since 2015, there has been a loss of more than 2,000—almost a 20% drop—so each health visitor has to work harder. I commend health visitors for the work they do but, overall, women are experiencing a drop in services.

He further added:

The disinvestment in health visiting is significant; there can be no solution to the problem while health visiting is not properly resourced.

We are grateful to the Minister for Mental Health and Inequalities, Jackie Doyle-Price MP, for sharing her very positive views on health visiting and the work of the Institute, following her recent visit to Manchester to find out more about health visitors and iHV PIMH Champions.

An extract from the debate – Jackie Doyle-Price MP said:

I want to come back to health visitors. I am a firm believer that health visitors are uniquely placed to identify mothers who are at risk of suffering, or are suffering, perinatal mental health problems and to ensure they get the early support they need. In fact, I visited the Institute of Health Visiting only a couple of weeks ago and heard a moving story from a new mum who had gone through a mental health crisis. It is striking that she had experienced all the feelings we have talked about—she felt there was something wrong with her, she could not bond with her baby, and she got more and more depressed and withdrawn about it. The other interesting thing about that case was that it was dad who felt utterly powerless to do anything. Only their relationship with their health visitor enabled them both to reach out for help.

I am under no illusions about the importance of health visitors. I was privileged to meet so many fantastic advocates for them as part of the NHS’s 70th birthday. They are our eyes and ears in so many ways, and they are our intelligence network in tackling adverse childhood events. I am full of praise for the important job they do in supporting new parents and families through a child’s early years. I am really pleased about the success of the Institute of Health Visiting perinatal and infant mental health champions training programme. Those 570 champions play a crucial role in spreading good practice and early identification of mental health problems.

Some hon. Members raised concerns about the decline in the number of health visitors. There was a substantial increase in the run-up to 2015, and there has been a fall since. I am bothered about that, so I will look at how we can encourage local authorities to alter that situation, recognising that in some areas local leaders have realised that health visitors can do so much more to deliver better outcomes for their communities. Blackpool, for example, has substantially increased the number of visits. I am really looking forward to seeing the outcome of that work, so that we can encourage that good practice in other local authorities.

 

On Thursday 5 July, the Minister for Mental Health and Inequalities, Jackie Doyle-Price MP, celebrated 70 years of the NHS with Institute of Health Visiting (iHV) Perinatal Mental Health Champions and Perinatal & Infant Mental Health Champions in Manchester.

During the celebration event, the Minister heard about the work of the health visitor, with a specific focus on the critical role that health visitors play in preventing mental illness, promoting mental wellness across the life-course and supporting/offering evidence-based interventions to families suffering from perinatal mental illness. She also heard a very powerful presentation from Jane Fisher, a mother with lived experience, on the importance of her relationship with her health visitor as part of her recovery.

Minister for Mental Health and Inequalities Jackie Doyle-Price meeting iHV PIMH Champions in Manchester to mark #NHS70

 

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

“5th July was such a special day for the NHS. We were delighted to celebrate its 70th year with some of our wonderful Perinatal & Infant Mental Health Champions in Manchester – a very appropriate location as health visiting started in Salford /Manchester in 1862 and there is a long history of Manchester supporting public health improvement. This was a great opportunity to share with the Minister the fantastic and essential work that health visitors and our Champions provide to mothers and their families.

“Perinatal mental health is key for all parents and their families – at the Institute we recognise the importance of this and have a range of accredited training programmes to ensure that health visitors and other health professionals have the correct information knowledge and understanding to support parents and families to promote and maintain their mental wellbeing. On marking the 70th birthday of the NHS, I am delighted to announce that the iHV has now trained over 1500 Perinatal & Infant Mental Health Champions – and, if each cascaded their knowledge to only 20 colleagues, then that’s over 30,000 healthcare professionals who have better insight to supporting perinatal and infant mental health – quite amazing!

“This celebratory event shone a light on health visitors and our amazing Champions who play such an important role in helping ensure all children have the best start in life.”

Minister for Mental Health and Inequalities Jackie Doyle-Price said:

“I was privileged to spend some of the NHS’ 70th birthday with such fantastic advocates for the Health Visiting profession.

“They really are our eyes and ears for good perinatal health, and do an important job in supporting new parents and families through a child’s early years. I know they are working under increasing pressures, and expect local authorities to make sure they support health visitors in communities across the country.”

Minister for Mental Health and Inequalities Jackie Doyle-Price meeting iHV PIMH Champions in Manchester to mark #NHS70

Andrea Johns FiHV, Professional Lead Wirral- 0-19 and Cheshire East- Health Visiting, commented:

“I was delighted to see that the Minister was focusing on health visitors on the NHS 70th birthday. The role of the health visitor is key to improvements in perinatal and infant mental health. Health visitors are highly skilled in identifying mental health issues and work closely with partner agencies to deliver high quality, evidence-based support in the community.”

Melita Walker FiHV, Mental Health Lead, Institute of Health Visiting, added:

“NHS70 for the health visitors who met with Jackie Doyle-Price will be remembered as a day of celebration and hope. It was brilliant to be able to share the great work that health visitors are doing and also have the opportunity to discuss the challenges and think collaboratively for solutions.”

Well, what a day we had yesterday (24 April) for our Perinatal and Infant Mental Health Conference: The Hidden Challenges!  Almost 200 people convened in Manchester including many of our Perinatal and Infant Mental Health Champions and those working alongside them.

Dr Cheryll Adams CBE opening the PIMH conference

This multi-agency conference was a jam-packed day – with internationally-acclaimed speakers, a theatre production and amazing brave mums and dads talking about their personal stories and lived-experiences. A big thank you to you all!

Documental Theatre at #iHVPIMH18

Amazing feedback

We had fab feedback from Twitter- and we haven’t yet finished going through all the evaluations!

“Amazing day at #iHVPIMH18. Best conference I have been to. Definitely increased my passion for providing quality PIMH services across the UK.”

“Thanks for an inspirational day with excellent speakers my head is overflowing but my heart is full of gratitude to those amazing women and men for sharing their experiences #iHVPIMH18

“Wow what a day.”

“Fabulous conference with inspirational and motivational speakers. Feeling re-energised and can’t wait to continue the excellent work happening in the North West to improve perinatal mental health care.”

“Thank you so much to everyone involved in #iHVPIMH18. It was emotive and inspiring. Lots to take forward into practice and even more passion to #turnthemapgreen

“Excellent day thank you”

“I can’t remember any conference before where I’ve felt so moved , inspired and awe struck by the speakers #IHVPIMH18

“An inspirational conference! Well done everyone who bravely shared their personal stories & all involved”

“Thanks so much for a really fantastic inspirational Conference!”

“Wow! a conference with a difference they said! I wasn’t expecting that—an amazing inspiring day, need time to digest all I have heard and been part of.”

“Thoughts after an amazing #iHVPIMH18 conference in Manchester! “There is always hope” “be consistent” and “talk to dads””

“Loved every second and feel very inspired by the whole day, thank you for the opportunity”

Fantastic and informative day. Thank you #iHVPIMH18

“Thank you 4 today. I have learned so much! An outstanding conference!”

“Thank you for an excellent day”

Storify

For those of you who could not either join us on the day or could not follow the #iHVPIMH hashtag on Twitter, we’ve collected and made a little “Storify” of the tweets so you can follow some of what was shared.

Posters

Well done to all our poster submissions at #iHVPIMH18 – we had lots of amazing posters shared about innovative support for perinatal and infant mental health.

Many thanks to Professor Dame Sarah Cowley and Dr Karen Stansfield for assessing all the poster submissions.

Delivering an e-poster at #iHVPIMH18

the audience enjoying the e-posters – complete with popcorn!!

Our poster winner was Catherine Lowenhoff, PhD student at Oxford Brookes University – Combining evidence from research and practice to produce a draft intervention framework to guide the support that health visitors provide to mothers with mental health problems.

Many congratulations to Catherine who was selected to present her poster to the conference audience – see photo below.

Catherine Lowenhoff, e-poster winner, delivering her poster to the audience at #iHVPIMH18

Catherine Lowenhoff being presented with her winner’s certificate by Dr Cheryll Adams CBE

Well done also to our 2 highly commended posters:

  • Jane Dickens (who collected the certificate in the photo below) and Lisa Milne from Bradford District Care NHS Foundation Trust – Revolutionising the Parent Infant Relationship: Bradford’s Parent Infant relationship Resource Cards;
  • Anulika Ifezue (unfortunately had left to catch her train, so we are sending her certificate to her) from Manchester University NHS Foundation Trust – Breaking professional and organisational barriers in delivering perinatal and infant mental health care.

Dr Cheryll Adams CBE presenting a highly commended certificate to Jane Dickens from Bradford District Care NHS Foundation Trust

Our fabulous pledge wall certainly gained some great foundations yesterday!

The pledge wall at #iHVPIMH18

New maps launched today by the Maternal Mental Health Alliance’s Everyone’s Business Campaign show that pregnant women and new mums in a quarter of the UK still cannot access lifesaving specialist perinatal mental health services, which meet national guidelines.

The Maternal Mental Health Alliance welcomes the encouraging signs of progress seen in some parts of the UK but raises the alarm: there is not progress for all parts of the country at the same rate, meaning right now, women and families still face a postcode lottery.

According to the new data, pregnant women and new mums in 24% of the UK still have no access to specialist perinatal mental health services (rated red on the map). The maps show that whilst many more women now live in an area coloured green on the map, meaning specialist perinatal mental health services are available in their locality, it is unacceptable that so many women and their families still cannot access essential care.

More than 1 in 10 women develop a mental illness during pregnancy or within the first year after having a baby. Women with the most severe perinatal illnesses need to be able to access vital specialist services wherever they live. If left untreated these illnesses can have a devastating impact on women and their families. In the most serious cases, perinatal mental illness can be life threatening: suicide is a leading cause of death for women during pregnancy and one year after giving birth.

When a woman lives in an area where she is able to access specialist services, with a team of trained staff, it can make all the difference to her quality of care, speed of recovery and support both for her and relationships with her baby and family.

Dr Cheryll Adams CBE, Executive Director iHV, said:

“The Institute of Health Visiting is fully committed to supporting  the Maternal Mental Health Alliance’s Everyone’s Business Campaign and, as active members of the Alliance, the Institute is delighted to see the progress which has been made to provide access to specialist perinatal mental health services for all mothers.

“It is unacceptable that there is still a lack of parity for mental health in the perinatal period and that suicide is still a leading cause of maternal death. These new maps show that much has been achieved, and the great strides are to be applauded – but we must press on, there is still much to do to turn the map green.

“Women with severe perinatal illnesses require timely referral to specialist perinatal mental health services, and health visitors are crucial – to not only accessing specialist perinatal mental health services, but they also work upstream, often preventing a potential mental health problem becoming a mental health crisis/severe mental illness. Thus, alongside supporting the call for continued funding of specialist perinatal mental health services, the Institute is urging additional investment to ensure there is a confident, competent, capable and committed universal health visiting service at every local level.

“To ensure that every mother (and her family) does indeed, get the right help, in the right place, at the right time, we need properly funded and supported pathways of care at every local level. It is most definitely #everyonesbusiness”

 

We are delighted to open the bookings for two new specialist conferences:

  • Breastfeeding: a public health priority
  • iHV National Multi-agency Perinatal and Infant Mental Health Conference: The Hidden challenges

Dr Cheryll Adams CBE, executive director iHV, commented:

“It is a privilege to able to offer these fabulous specialist conferences with such distinguished speakers to support the health visiting profession. Please do take advantage of an iHV accredited event with great CPD and the latest updates in these two extremely important areas of health visiting practice. Book your place soon as we expect there to be pressure on places!”

Breastfeeding: a public health priority

  • 19 April 2018, in London
  • Accredited conference
  • This event is joint hosted by the iHV and the Royal Society for Public Health (RSPH), and is supported the World Breastfeeding Trends Initiative (WBTi).
  • The conference programme is designed to illustrate the need for support and show examples of what integrated services can achieve in the community.
  • The World’s Breastfeeding Trends initiative findings and recommendations which will be shared during the day can strengthen health visitor practice and improve public health if implemented.
  • Earlybird tickets (for iHV members and non-members) are available until 16 March 2018

iHV National Multi-agency Perinatal and Infant Mental Health Conference: The Hidden challenges

  • 24 April 2018, in Manchester
  • Accredited conference
  • This multi-agency conference is a brilliant opportunity to get the latest updates and evidence in perinatal and infant mental health.
  • As well as stimulating learning through debate and discussion via presentations from internationally-acclaimed speakers, the day will offer focused opportunities to learn from each other through sharing best and promising practice in PIMH.
  • A call for abstracts is currently open – providing the opportunity to showcase your work in Perinatal and Infant Mental Health (PIMH).  Abstracts are welcome in areas of new research and local innovations in the fields of perinatal and/or infant mental health.
  • Earlybird tickets (for iHV Champions, iHV members and non-members) are available until 29 March 2018, so don’t miss them! Limited student places also available.

We always seek to ensure our activities comply with the UNICEF Baby Friendly Initiative – our events are not and never will be sponsored by the formula milk industry. 

On 23 September 2017, the iHV was invited to give a presentation at the European Midwives Association’s (EMA) annual conference, this year dedicated to Perinatal Mental Health (PMH). The conference, hosted by the national organisation of Spanish midwives known as Federacion de Asociaciónes de Matronas de España (FAME) in Madrid, was attended by high level representation from 35 European member states.

Melita Walker (iHV Perinatal Mental Health Lead) presented on behalf of the iHV on UK Policy and best practice in Perinatal Mental Health, discussing the UK approach to PMH and national policy and research direction for the UK.

Melita Walker presenting at the EMA annual conference

The conference also heard from Mental Health Europe Director, Maria Nyman, who introduced the European landscape on Perinatal Mental Health, highlighting existing opportunities to further advance the issue at EU level. Presentations throughout the day shared good practice in PMH from across Europe and also the challenges faced by respective nations.

EMA annual conference 2017

Following the formal presentations, Melita joined a working group to think through what the direction of travel should be in relation to PMH and the education and training for midwives. The agreed action from the workshop was that the EMA would develop a position statement on PMH that will enable the mental health of mothers and fathers to be seen as important as physical needs during the perinatal period. There was consensus that PMH should be a “red thread”, running through all midwifery care, not separate, or as an add-on, and that midwifery training should also be designed to integrate mental health alongside physical health.

Melita Walker commented:

“It was a privilege to represent the iHV at this event.  The EMA is a fantastic organisation, dedicated to improving outcomes for women and their families. The Institute has worked closely with our colleagues in midwifery services and understands the important role they play in achieving good health outcomes, which is why we have recently developed our Maternity PMH Champions programme. It was wonderful for the iHV to support this event, to share our learning and to contribute to raising parity of esteem for mental health across a huge geographical area. PMH is immensely complex and no one agency can achieve good outcomes alone. It is only by working together, in partnership, that we will realise our collective aspirations for a mentally well society.”

The Institute of Health Visiting (iHV) responds to the Royal College of Midwives (RCM) report ‘Every mother must get the help they need’ report published this week.  The report was inspired by the Change.org petition of Lucie Holland whose sister, Emma, died in tragic circumstances as a result of perinatal mental illness.

Dr Cheryll Adams CBE, executive director of the Institute of Health Visiting, said:

“The remarkable efforts of Lucie Holland and her family following Emma’s tragic death serve as a moral imperative for national commissioning bodies, and also for every commissioner at every local level, so that such a tragedy should never happen again. We need to broaden perceptions of mental health, so that all women and their families, and all health and social care professionals consider mental health equal to physical health.”

Lucie set up the petition in 2015 calling for better awareness and care for those affected by perinatal mental illness. Her petition received thousands of signatures and many people left heartfelt comments about their own experiences. The RCM collated and analysed all the comments to form the report ‘Every mother must get the help they need’.

Dr Adams continued:

“It is vital that all practitioners working alongside women and their families in the perinatal period are competent, confident and committed to ensuring that the right care, at the right time, is available in the right place for all women and their families. Specialist midwives and specialist health visitors should be in post at every local level as part of a comprehensive specialist perinatal mental health service offer. The Institute is committed to working in partnership with all agencies to achieve the highest standard of care all mothers and their families deserve.”

Women with mental health problems during and after pregnancy reveal the impact of low rates of specialist referral, long waits, as well as lack of consensus over medication and little support for their partners, in a survey published today (22 February) by the Royal College of Obstetricians and Gynaecologists (RCOG) and supported by the Maternal Mental Health Alliance (MMHA).

The survey of over 2,300 women who had given birth in the last five years in the UK, explores their experiences of perinatal mental health problems, engagement with healthcare professionals and the quality of care they received.

Dr Cheryll Adams CBE, executive director, iHV, said:

“The Institute of Health Visiting, a member of the Maternal Mental Health Alliance, welcomes the results of the ‘Women’s Voices’ survey run by the Royal College of Obstetricians and Gynaecologists and launched today.

“This survey gives real life evidence on the level of support that women receive when suffering from perinatal mental illness (PMI) – and the variation there is in the level of services across the country.  Health visitors are key healthcare professionals who are well-placed to identify and offer support to women suffering with PMI.  However, our own surveys have shown that, although parents will turn to their health visitor for support,  there is often insufficient time for the health visitor to offer the level of support required.

“We, at the iHV, deliver perinatal mental health (PMH) and infant mental health training to ensure standardised practice for health visitor professionals and the families they work with.  Our PMH training has now been delivered to well over 10,000 health visitors and others across England. However, for this training to have the impact it should, more health visitors need the time to use what they have learnt to improve services, especially at the recommended contacts.

“Perinatal mental health is an incredibly important area of healthcare which can have a negative effect on the health and wellbeing of babies and families and ultimately on our society when we don’t recognise it early. Health visitors have always made a huge contribution to supporting pre-school children and their families and are the best-placed professional to help give all children the best start in life during the early years of life.”

The Institute of Health Visiting (iHV) is attending and presenting at the International Marcé Society Biennial Scientific Meeting being held this week (26-28 September) in Melbourne, Australia, with the theme Frontiers in Perinatal Mental Health – looking to the future.

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

“The iHV is delighted to attend the International Marcé conference, where we can share best practice on our Perinatal Mental Health (PMH) Champions training and also learn about what works well in other countries. By 2016, a total of 577 PMH champions have been trained across England and they, in turn, have rolled out the training to in excess of 10,000 health visitors and others.”

Dr Adams continued:

“Whilst our iHV training was designed for health visitors, many other professions have benefitted during the roll out including midwives, general practitioners and mental health workers. As a result, the iHV has now designed and delivered multi-professional champions training and a range of direct delivery training. As encouraging as the reach, has been the many effects of the training on service transformation at a local, regional and national level.”

Melita Walker, Professional Development Officer/ Perinatal Mental Health Lead at the Institute of Health Visiting, is presenting her poster on the iHV’s Health Visitor Perinatal Mental Health Training – changing practice and systems together.

 

Melita Walker, Professional Development Officer/ Perinatal Mental Health Lead at the Institute of Health Visiting, presenting her poster at the International Marcé Society Biennial Scientific Meeting in Melbourne, Australia.

Melita Walker, Professional Development Officer/ Perinatal Mental Health Lead at the Institute of Health Visiting, presenting her poster at the International Marcé Society Biennial Scientific Meeting in Melbourne, Australia.

The Institute of Health Visiting (iHV) welcomes the innovative new mapping tool, launched online today by the National Lottery funded Mums and Babies in Mind project, to help professionals who are trying to transform perinatal mental health (PMH) services for mums with mental health problems during pregnancy or the first year after birth.

Using this unique mapping tool, professionals will be able to rate their local services against national standards to identify strengths and gaps where more work is needed. The tool has seven themed areas, which set out key standards for the different services and processes that should ideally exist in each local area. It also pulls out cross cutting themes, like support for new dads.

Dr Cheryll Adams, Executive Director iHV, said:

“The Institute of Health Visiting, a member of the Maternal Mental Health Alliance, is delighted to support the launch of this new mapping tool which will help local PMH leaders, many of whom are health visitors, to identify any concerns in their local PMH support systems and what they need to do to address them to ensure that every mum and her family get the support that they need.”

Dr Adams continued:

“We, at the iHV, are also extremely pleased that the new tool includes recommendations for iHV Champions and Specialist Health Visitors in every service, as well as mandatory training in PMH and IMH (infant mental health).  This strengthens the work that the iHV has done and continues to deliver in PMH and IMH training and ensuring standards for health visitor professionals and the families they work with.”

Download and use the mapping tool: www.maternalmentalhealthalliance.org/mumsandbabiesinmind/mabim-tools

Explore new Mums and Babies in Mind online hub: www.maternalmentalhealthalliance.org/mumsandbabiesinmind