Tags: report

iHV publishes Mental Health Department Report 2021/2022

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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Download and read iHV Mental Health Department Report 2021/22

iHV welcomes new MMHA economic research report

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.
Download MMHA report - The economic case for increasing access to treatment for women with common mental health problems during the perinatal period.

Download Centre for Mental Health summary of the research and analysis its implications for policy and practice - A sound investment

Download Professor Jane Barlow report - Specialist Health Visitors in Perinatal and Infant Mental Health (Sp HV PIMH) Report

 

Oxford University study recommends commissioning of Sp HV PIMH throughout UK

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.”

Download Specialist Health Visitors in Perinatal and Infant Mental Health (Sp HV PIMH) Report

iHV responds to House of Lords ‘Children in Crisis’ report

iHV responds to the House of Lords’ Public Services Select Committee report published today into how public services support children and families – Children in crisis: the role of public services in overcoming child vulnerability.

Baroness Armstrong of Hill, Chair of the Select Committee, reports:

“We found a crisis in child vulnerability. Over a million children are now growing up with reduced life chances, too many ending up in care, too many with poor health outcomes… The crisis has grown worse during the pandemic, but it’s been building for many years, partly due to large cuts in early intervention funding.”

This important report is a stark reminder that underinvestment has created worse outcomes for children and higher costs for the taxpayer, as children slip through the gaps between services and do not get the support they need. The report includes clear recommendations for a national strategy for child vulnerability, and also recommends that ‘health visiting’ should be key partners in delivering Family Hub provision.

Responding to the report, Alison Morton, iHV Executive Director, said:

“Today’s hard hitting ‘Children in Crisis’ report lays bare the preventable suffering and misery that has been caused to our nation’s children whose needs have been largely overlooked.

“Cuts have consequences and the poorest children have been hit the hardest. It is time for the Government to prioritise children in their plans to ‘Build Back Better’, particularly babies and young children who have been overlooked the most.

“We call on the Government to make good their pledge to ‘rebuild health visiting’. Health visitors provide a vital infrastructure of support for all families, and a crucial safety-net, identifying vulnerable babies and young children.

“The Government say that they will maintain the Public Health Grant, but this is being maintained at a level that is too low to fund the number of health visitors needed to support all families and identify vulnerable babies and young children. Following years of cuts since 2015, there is now a national shortage of 5,000 health visitors in England and the profession faces its biggest workforce challenge in living memory. As a result, despite health visitors’ best efforts, the service is now so stretched that many families are not getting the support they need, and vulnerable babies and young children are being let down.

“Investment in health visiting is needed to provide the prevention and early intervention support to stop this growing tsunami of children in crisis. This cannot wait any longer – our nation’s children deserve better.”

Read today's report - Children in crisis: the role of public services in overcoming child vulnerability.

iHV welcomes Petitions Committee Report – Impact of COVID-19 on new parents: one year on

The iHV welcomes today’s Petitions Committee Report which calls on the Government to publish a dedicated COVID-19 recovery strategy for new parents. 12 months on from the Petitions Committee Report last year, it is clear that the pandemic continues to impact on new and expectant parents.

The Petitions Committee Report – Impact of COVID-19 on new parents: one year on calls for:

  • extra funding and resources to allow catch-up mental health support for new parents and to boost perinatal mental health services
  • funding for local authorities to arrange in-person visits to new parents by councils, voluntary organisations or health visiting staff by the end of the year
  • a review of monitoring and enforcement activity relating to employers’ health and safety obligations to pregnant women
  • legislation on the planned extension of redundancy protections for new and expectant mothers
  • a review into the funding, affordability and provision of childcare, and the sustainability of the childcare sector

Alison Morton, iHV Executive Director, said:

“We thank the Petitions Committee for their ongoing work championing the needs of new and expectant parents which have been largely overlooked during the pandemic. This hard-hitting report adds to the growing weight of evidence that has helped raise this important issue. It recognises the vital role that parents play in raising the next generation and the devastating and far-reaching impact that the pandemic has had on babies, young children and their families.

“We share the Committee’s disappointment that despite the government’s pledges to ‘build back better’, this has not translated into any tangible action or investment to make the changes that are needed to strengthen the support that families receive during these important earliest years of life.

“We support the calls for investment into the health visiting workforce which adds weight to the groundswell of support that the profession has received from a multitude of partners in the current #TurnOffTheTaps campaign. We join with them in calling on the Government to invest in giving children the best start in life.

“It is difficult to understand what more evidence policy makers need to take this matter seriously. We are currently wasting billions of pounds of taxpayers’ money every year on ‘getting it wrong’ with spiralling costs of late intervention. Babies, young children and families need action now – this cannot wait any longer.”

Read Petitions Committtee news story

New MMHA report evidences key role of HVs in addressing the increase in mental health needs of families

The iHV is delighted to have supported the launch of the new report on maternal mental health and the services that supported women and their families during the COVID-19 pandemic. We would like to put on record our thanks to the Alliance for undertaking this work and creating a public opportunity today for us to come together, to think together about the findings and their important implications for families now – need is great and families can’t wait.

 


Today’s report brings together, for the first time, all of the available data collected during the pandemic looking at the mental health challenges that women during and after pregnancy have faced. The evidence shows a significant increase in maternal mental health problems across the UK over the last 12 months

Speaking at the launch event today, iHV Mental Health Lead, Melita Walker highlighted the important role that health visitors play in identifying and supporting families experiencing mental health challenges, saying:

“Health visitors are qualified nurses or midwives who go on to study at a specialist level in public health to become health visitors. Every family has a health visitor, and they are there to support all members of the family to enjoy good health. Health is affected by a multitude of things so health visitors may be working with families to support a very broad range of need, and those needs, left unsupported as this report shows, can actually tip families into experiencing mental health problems. Health visitors have a vital role in promoting good mental health, preventing mental health problems, identifying them early, offering evidence-based interventions and care coordination when more specialist services are needed. Family mental health and wellbeing is “the bread and butter” of health visiting.

The perinatal period is a vulnerable time for the acute onset and recurrence of mental disorders. When these vulnerabilities are combined with the impact of a pandemic, mental health problems and health inequalities are affected further. We have seen parents struggling with isolation, and sadly, we are seeing an increase in, domestic abuse, child poverty, substance misuse and child maltreatment. Rates of mental health problems are increased and inequalities are widening.  The impact of lockdown has been unevenly distributed and families with lower incomes, from Black, Asian and minority ethnic communities and young parents are experiencing the most detrimental consequences due to compounding factors like overcrowded housing with lack of outdoor space, the effects of poverty, which all have an impact on parental stress, anxiety and predisposition to mental illness. The family centred holistic role of the health visitor cuts across and can make a difference in all of these areas- thus positively and proactively supporting good family mental health alongside a range of other health outcomes.

That said, health visitors can only make a difference if we have sufficient numbers of them and this report highlights that health visitors in England went into the pandemic in a hugely depleted state due to years of cuts to the health visiting service. The first two years of a child’s life are important, and the right support and guidance for families at this time can make a big difference to their long-term outcomes. HVs can be a lifeline for families and the iHV ‘s position from very early on in this pandemic was that there was “more than one frontline” and sustaining support for families’ needed to be a priority and that health visitors should not be redeployed.

It is important to note that many local authorities in England did not redeploy their health visitors, but 65% redeployed at least one health visitor and redeployment ranged from no health visitors being redeployed in some areas, to 63%, of the HV team being redeployed. Over 11% of local authorities lost over a quarter of their HVs. So, we can see, with redeployment rates differing substantially, young children and families’ access to health visiting services was determined by their postcode.

The iHV campaigned vigorously from the outset about redeployment and we were very relieved when England’s chief nursing officer Ruth May , Public Health England & the Local Government Authority sent a letter to all the CNOs stating that HVs provide ‘frontline’ work and should not be redeployed.

The learning we have now, and the swell of collective voices, hopefully means that we can be confident going forward in this and any future pandemic, that health visitors will remain on their own frontline. We are also very optimistic that the Leadsom review will contain some significant measures to strengthen the HV offer for families.

There has been a lot of learning from and throughout this pandemic and we must pay tribute to all the health visitors who continue to work really hard in some very challenging circumstances to find ways to stay alongside families to make sure they receive the care and support they need for their mental health. We have heard of some fantastic examples of health visitors turning to new ways of working and to get all of this up and running in the speed that they have is commendable.

Health visitors are telling us that virtual and digital help has allowed them to reach parents in the absence of being able to visit, and there may well be some of the virtual offers kept after restrictions have eased. They are also telling us very firmly, as is the emerging evidence included in this report, that virtual should not replace face to face contacts.

The research is showing us that there are significant increased MH problems in parents who have experienced becoming a parent during the pandemic. If we are to meet this need then all services need to work together as a system, and all parts of that system need to be strong.

We know a robust home visiting – health visiting service works- we need to build back our health visitor numbers because as this report shows, health visitors are a critical part of the solution for achieving good family mental health and wellbeing”.

Click here to access the new report: Maternal mental health during a pandemic

Preliminary insights of the Early Years Healthy Development Review

Preliminary insights of the Early Years Healthy Development Review were outlined by Rt Hon Andrea Leadsom MP at the APPG on Conception to age two meeting, held on Tuesday 19 January 2021

At the online APPG, the First 1001 Days Movement ‘s Working for Babies: Lockdown lessons from local systems report was formally launched – read our news story on this.

Speaking at the online event, Andrea Leadsom said that the report findings ‘chime totally’ with what the Early Years Healthy Development Review has found.

The F1001D report presented hard-hitting findings about the direct and indirect harm to babies, young children and their families caused by the pandemic during the Spring 2020 lockdown. These “hidden harms” were broad and significant, and experienced unevenly depending on family circumstances and background. The report also highlighted how there are often ‘baby blind-spots’ where babies’ needs are overlooked in policy, planning and funding.

Andrea Leadsom’s Early Years Healthy Development Review, due to be published at the end of February, will look at issues around joining up services; improving the use of digital services to reach parents; data sharing and local leadership.

She told the APPG attendees that evidence is emerging that services for babies have been ‘particularly better’ since the latter part of last year, when second and third lockdowns took place, largely because staff were not moved away as much as they had been in the first lockdown.

The Early Years Healthy Development Review will give six recommendations which, by the time it is launched in February, Andrea Leadsom hopes will gain the approval of all the political parties so that this early years review will be ‘the one that sticks and endures’ for many years to come.

She talked about the possibilities of harnessing the benefits of digital technology to provide consistent and joined-up support to new parents. The use of data-sharing will enable professionals to provide ‘much more focused support on what families need’ and less time will be spent for parents retelling their story to different professionals.

Andrea Leadsom thanked early years professionals for their amazing work during the lockdowns ‘who have done so much to support new families in such difficult period’ and to reassure them that ‘these lessons would be learnt’ and reflected in the Early Years Healthy Development Review.

Watch and listen to APPG proceedings on 19 January 2021 including the launch of the F1001D report and presentation by Rt Hon Andrea Leadsom MP (starting at 29:51)

 

iHV welcomes new F1001D report – Working for Babies: Lockdown lessons from local systems

iHV welcomes a new report published today by the First 1001 Days Movement (F10001D) which provides insight into the impacts of COVID-19 and the Spring 2020 lockdown on babies.

The report, Working for Babies: Lockdown lessons from local systems, presents hard-hitting findings about the direct and indirect harm to babies, young children and their families caused by the pandemic. These “hidden harms” were broad and significant, and experienced unevenly depending on family circumstances and background.  Historically inadequate or insecure funding, and a rising tide of need, has inhibited the ability of some services and local systems to respond to the needs of babies and their families during the pandemic. There were often ‘baby blind-spots’ where babies’ needs were overlooked in policy, planning and funding.

However, the report also provides some “good news stories” of organisations and systems which reacted and adapted positively to the pandemic. The report introduces the concept of “baby-positive” local responses and provides the beginnings of a formula for what good local systems should look like. In particular, it sets out the positive difference that was made by professionals who were connected to each other, and to their communities, and were empowered to meet families’ needs.

Most importantly, the report seeks to ensure that lessons are learned for the future of service provision for this age group. It provides further evidence of the importance of many things that the iHV campaigns for, such as clear leadership, a focus on babies’ needs, and a joined-up response.

Alison Morton, Acting Executive Director of the iHV said:

“This report adds further weight to the growing body of evidence on the direct and indirect impact of the COVID-19 pandemic on families with babies and young children. The message is clear, despite the indisputable evidence that the first 1001 days are the most crucial period of human development, babies and young children have largely been forgotten in the national pandemic response. Now we know better, we must do better.

“We hope the report brings a much-needed tipping point for change. It provides a powerful impetus to the Government to focus their efforts on the things that matter most by investing in our youngest citizens, to put things right and achieve their ambition to ‘build back better’.”

Working for Babies: Lockdown lessons from local systems

Download F1001D report - Working for Babies: Lockdown lessons from local systems

The report will be officially launched today at the APPG on Conception to Age Two meeting. For those not able to secure a space on at the APPG meeting itself, F1001D will be live streaming it at 3pm this afternoon via the Parent Infant Foundation YouTube channel. It will also be available to watch back later.

Please get involved by talking about the report on your social media channels! Get involved with the conversation and the report by using the hashtags #WorkingForBabies  #BabyBlindSpots on social media.

 

 

iHV welcomes NCB Report “Whatever it takes”

iHV very much welcomes the NCB’s clear analysis and recommendations published in its report “Whatever it takes”: Government spending on children and young people – the impact of the coronavirus pandemic and the 2020 Spending Review.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“This NCB Report is a superb and clear analysis of the crises for children at the moment and, amongst other recommendations, it recommends investing in the early years and health visiting.”

“We hope that many interested parliamentarians and others will take the opportunity to attend the APPG for Children taking place this afternoon to discuss its contents.”

Parliamentarians will be debating the implications of this analysis at 4:30-6pm on Monday 14 December at a meeting of the All-Party Parliamentary Group for Children. Children, young people and parents who participated in the #GiveUsAChancellor campaign will also be presenting on the areas where they want to see future government spending.

Read NCB Report - “Whatever it takes”: Government spending on children and young people - the impact of the coronavirus pandemic and the 2020 Spending Review

 

Disappointment at Government Response to Petitions Committee report

The Government has given their response to the Petitions Committee’s landmark report on the impact of COVID-19 on maternity and parental leave.

The report was the result of an extensive inquiry following an e-petition calling for the Government to extend maternity leave by 3 months with pay in light of COVID-19 which received over 226,000 signatures, and to which Dr Cheryll Adams contributed some evidence via Zoom in May earlier this year (see iHV at Petition Select Committee).

See also iHV responds to Petitions Committee report: impact of COVID-19 on maternity and parental leave

Dr Cheryll Adams commented on today’s news on the Government Response:

“The Government Response to the report by the Petitions Committee’s recommendations on the impact of COVID-19 on parental leave is a disappointing response by government to such powerful lobbying by parents. So many new families have struggled during the past 6 months and more acknowledgement of that, in the form of positive responses to at least some of the recommendations, would have meant that they felt more valued in their essential role of bringing up the next generation.”

Read Petition Committee express disappointment at Government response to its report on impact of Covid-19 on maternity and parental leave

Read The impact of COVID-19 on maternity and parental leave: Government Response to the Committee’s First Report