Mothers in England fare best when it comes to perinatal mental health services, but provision is patchy everywhere, a new report finds
“Over the last 10 years, there has been a growing understanding of the importance of specialist care for maternal mental health, which has led to welcome improvements across the UK. However, it’s crucial that this momentum and commitment is maintained." Dr Alain Gregoire, consultant perinatal psychiatrist and president of Maternal Mental Health Alliance
Pregnant women and new mothers are not receiving appropriate mental health care because the NHS isn’t meeting its targets, a new report has found.
The report from the Maternal Mental Health Alliance (MMHA), which analysed FoI data from 70 NHS trusts and boards across England, Wales, Scotland and Northern Ireland, found a disparity in the pattern of perinatal mental health care across the UK. In 2016, the UK government promised to spend nearly £300m on specialist care for expectant or new mothers in England. The figures from MMHA, however, show that there are still large gaps in provision.
While there is some specialist provision across most of the UK, with increased investment everywhere, there is a strong disparity between the four nations, with Northern Ireland faring worst. Two of the country’s five health and social care boards have no specialist multi-disciplinary team to help mothers dealing with perinatal mental health difficulties. Northern Ireland also lacks a mother and baby unit for new mothers with serious mental health issues and in need of in-patient care. A spokesperson for Northern Ireland’s Department of Health said its five boards had appointed staff to community perinatal mental health teams, and all were accepting referrals. It added that they were working to identify a location for a mother and baby unit.
The Royal College of Psychiatrists has drawn up a set of quality standards for perinatal care. The minimum standard of care that women, babies and families should receive is defined as PQN standards type 1. In Wales, none of the health boards met these standards.
A Welsh government spokesperson told the BBC it had invested in specialist perinatal mental health services and there were dedicated teams within every health board in Wales.
In Scotland, only 14% of health boards met the Royal College standards. A spokesperson for the Scottish government said, however, that staffing across perinatal mental health services had increased significantly and that it was committed to improving services.
England is the nation with the most comprehensive care, but even there only 16% of the specialist perinatal mental health community teams met these standards.
Further, the NHS in England is not on track to meet the goals it set for this year in its Long Term Plan. Only about half of trusts are offering mental health care from pre-conception to two years after birth, or offering support to partners.
The MMHA figures show that almost three quarters of mental health trusts in England forecast an underspend for 2022. Across the UK, more than £15m allocated to improve maternal mental health in 2022 was not spent.
The reason most commonly cited by the health authorities for the underspend is related to recruitment – either teams are not given enough certainty in the funding to hire, or staff are just not available. One health care professional told the MMHA: “We are working far beyond funded capacity, which – as predicted and highlighted repeatedly – is now manifesting as increased sickness, stress, burnout and increased staff turnover.”
Dr Alain Gregoire, a consultant perinatal psychiatrist and the president of MMHA, said: “Over the last 10 years, there has been a growing understanding of the importance of specialist care for maternal mental health, which has led to welcome improvements across the UK. However, it’s crucial that this momentum and commitment is maintained.
“National and local decision-makers must ensure that allocated resources reach clinical services to ensure that mothers, babies, and families can access the care they need. We must grasp this exceptional opportunity to make a real and lasting impact on the lives of women, babies, and future generations.”
This valuable report from the Maternal Mental Health Alliance illustrates that, although improvements have been made, provision of perinatal mental health services is still very uneven throughout the country. Approximately one in five women experience mental health problems in the perinatal mental health period, often having a severe impact on their ability to lead a normal life. Good mental health services can be transformative, which is why investment in these services is so important.
It’s striking to find that some NHS trusts are underspending on their perinatal mental health budget because they cannot recruit the staff they need. Having provided a sum of money to create these services, the government now needs urgently to put measures in place to address the shortage of mental health professionals to staff the services.