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Wednesday, 18 April 2018

One in four UK regions lack specialist mental health care for mothers

Written by Ella Pickover

Pregnant women and new mothers in a quarter of the UK still cannot access specialist perinatal mental health services, according to new research.

The Maternal Mental Health Alliance (MMHA), a coalition of organisations involved in the mental health and wellbeing of pregnant and new mothers, has published a series of maps highlighting the areas which are best and worst for access to the specialist services.

According to the group, pregnant women and new mothers in 24% of the UK still have no access to specialist perinatal mental health services.

It said despite improvements, women and families still face a "postcode lottery" of care.

Around one in 10 women develop a mental illness during pregnancy or within the first year after having a baby.

The MMHA said specialist perinatal mental health services can "save lives" as well as improve the quality of life for pregnant women, new mothers and their babies.

In England there appears to be significant improvements compared to previous years.

Although not directly comparable, a report from the National Childbirth Trust (NCT) last year suggested in 2014, only 3% of local health bodies had a perinatal mental health strategy in place and most NHS trusts do not provide any perinatal mental health service.

But the latest map shows that in England 51% of areas are green, which means specialist perinatal mental health services are available for women in that area.

Across 14 regions in Scotland just area one, Greater Glasgow and Clyde, is green. Half are red, meaning women in these areas have "no provision".

In Wales, Powys is marked as "red" while the other regions have some level of care.

And in Northern Ireland, the whole country is red, with the exception of Belfast which has some level of perinatal mental health care.

Dr Alain Gregoire, chairman of the Maternal Mental Health Alliance, said: "Over ten years ago national guidelines said that specialist perinatal mental health services should be available for all women who need them.

"This still hasn't happened. We want to celebrate the new perinatal services that have been set up, but these maps show that there is still an urgent need for change on the ground.

"For women and families to be able to access specialist services, we need to see funding across all four nations of the UK.

"The job is not yet done. Women and families across the UK need this map to turn green."

Commenting on the research, Gill Walton, chief executive and general secretary of the Royal College of Midwives, said: "There have been improvements and we are making progress but there is still much, much more to be done.

"This is so important because if women do not get the services they need, the consequences can be fatal.

"These updated maps highlight again that our services are still a postcode lottery and not as good as they should be.

"We need to see our governments and our NHS providing the very best perinatal mental health services for all women across the UK irrespective of where they live."

Dr Ali Wright, vice president of the Royal College of Obstetricians and Gynaecologists, added: "The Government has made maternal mental health a top priority, but these maps show a stark picture of an NHS in which women are let down during what should be one of the happiest times for them and their families.

"We must act now to ensure all pregnant women and new mothers are supported to access the treatment, care and support they need."

NHS England's national mental health director, Claire Murdoch, said: "As recently as 2014 only 3% of the country had good access to perinatal mental health care, and as the MMHA itself acknowledges, services have since expanded significantly, as part of a £365 million package of investment, which helped an additional 6,000 women access care in the past year alone."

A Scottish Government spokesman said: "Good perinatal mental health care is vitally important in improving outcomes for mothers and their young children. This is why we have funded a national Managed Clinical Network (MCN) on perinatal mental health.

"The MCN brings together specialists on perinatal mental health, nursing, maternity, and infant mental health, and is designed to improve the recognition and treatment of perinatal mental health care.

"The Network is currently delivering on its workplan, which includes assessing current provision across all levels of service delivery in Scotland.

"Our aim is that all women, their infants, and families, have equity of access to the perinatal mental health services they need across all of Scotland."

A spokeswoman for the Department of Health in Northern Ireland said: "All HSC Trusts have implemented and adapted the regional Integrated Perinatal Mental Health Care Pathway.

"The updated pathway reflects current NICE guidelines and provides guidance to all health and social care professionals who come in contact with women in the antenatal and postnatal period.

"It sets out key standards of care and service requirements across primary care, core mental health services, child and adolescent mental health services, specialist inpatient services and the role of specialist community Perinatal Mental Health Teams."

A Welsh Government spokeswoman said: "We are committed to improving maternal mental health services, and are pleased the rapid progress that we have made in Wales has been recognised.

"Since 2015 we've invested £1.5 million a year in community perinatal mental health teams across Wales, which help identify, treat and manage mental ill health before and after childbirth.

"There are now community teams in every health board area in Wales. We can confirm that perinatal mental health service are also available in Powys.

"We are exploring options to ensure mothers can receive more intensive and inpatient perinatal support in Wales without being separated unnecessarily from their babies and families."

Labour pledges additional health visit for new parents

New parents should receive extra help from a health visitor to keep up breastfeeding rates, Labour has said.

An additional visit from a health visitor would also help spot any postnatal maternal health problems, according to the party.

Labour's shadow health Secretary Jonathan Ashworth said that health outcomes for babies and young children in the UK are "stalling", as the party said that it would fund an additional health visit when babies are between three and four months old.

Speaking at the Breastfeeding: A Public Health Priority conference in London, Mr Ashworth will say: "After many years of progress, health outcomes for babies and young children in the UK are stalling.

"We are lagging behind most other high-income countries on mortality, breastfeeding and obesity rates.

"The future of health visiting services is at a critical juncture. David Cameron and Theresa May used to boast of their commitment to increase the number of health visitors. Yet we have actually seen health visitors cut by more than 20% in just over two years.

"We must do better in England where families generally receive the lowest level of universal health visiting support when compared to the other UK nations, both in numbers and quality of universal contacts received."

He will add that under a Labour government, an additional £25 million would be ploughed into health visiting services to find an additional visit.

Meanwhile, a survey of health visitors released to mark the conference - hosted by the Institute of Health Visiting, Royal Society for Public Health and the World Breastfeeding Trends Initiative UK (WBTi) at the Royal Society for Public Health - found that more than a quarter (28%) felt their ability to support breastfeeding mothers had decreased.

Almost 800 health visitors were also asked about the reasons why mothers stop breastfeeding before they plan to.

Around two thirds cited attitudes towards breastfeeding mothers and 58% said a lack of professional support.

Meanwhile, more than half reported cuts to breastfeeding support groups or specialist support services in their local area.

Dr Cheryll Adams, executive director of the Institute of Health Visiting, said: "Once again, we quantify the devastating effects of the cuts to public health budgets which started in 2015. We know that this situation will worsen up until 2020.

"Such cuts are so counterproductive to the public's health.

"Giving every baby the best possible start in life has many benefits for their health throughout the life course. Breastfeeding is particularly beneficial, as a protective factor for an individual's future health."

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