Despite the roll-out of new perinatal mental health units across England, some pregnant women and new mothers are being denied help
“We know all too well how important the first 1,000 days of a child’s life are. Failing to support new mothers during this crucial period will have an unfathomable human cost.” Rosena Allin-Khan, MP
Almost 200,000 women with perinatal or postnatal mental health problems are unable to access NHS support, an FOI request has found.
The Guardian has reported that even women who do receive mental health help have to wait up to 19 months to start treatment because perinatal mental health services are overstretched.
One in four mothers develop a mental health problem relating to pregnancy or birth. Conditions include postnatal depression, postpartum psychosis and post-traumatic stress disorder as the result of a traumatic birth.
The data emerged in response to freedom of information requests by Dr Rosena Allin-Khan, Labour’s former shadow minister for mental health, to England’s 54 NHS mental health trusts. Last year 11,507 women who sought care for perinatal mental health problems did not get any after they had been assessed, according to figures provided by the 34 trusts that responded to the requests.
By extrapolating those findings to the other 20 trusts that did not release data, it is possible to estimate that 18,953 mothers across England as a whole were denied care, Allin-Khan said.
“It is an absolute scandal that new mothers are facing long waits for mental health services and all too often end up being turned away. No mother should be left behind to suffer in silence,” Allin-Khan told the Guardian.
“We know all too well how important the first 1,000 days of a child’s life are. Failing to support new mothers during this crucial period will have an unfathomable human cost.”
Some trusts performed worse than others. In 2022-23, the Southern Health mental health trust did not provide treatment for 1,644 women seeking perinatal mental health care once it had assessed them. It “closed” their referral. In Essex 929 women were refused help, as were 924 in Kent and Medway
By comparison, only one woman who sought care from the Berkshire mental health trust was denied it last year, along with one from the Norfolk and Suffolk mental health trust.
Dr Alain Gregoire, the president of the Maternal Mental Health Alliance, said that the delays were caused by services struggling to meet demand as a result of having significant shortages of doctors, nurses and therapists.
“Staff are working absolutely flat-out but can’t deliver the amount of care they should be delivering. So they are having to make clinical decisions about who gets priority. No one is saying ‘don’t see this woman’. They just don’t have the capacity to do it,” he said.
“It is rationing of care at a clinical level because there just isn’t the capacity to deliver that care, largely because there aren’t enough staff.”
Angela McConville, the chief executive of parenting charity NCT, told the Guardian: “The lack of mental health support services for pregnant women and women in the postnatal period is now at a stage where we would consider them to be dangerously patchy and unreliable. Access … remains a postcode lottery.
“Services are inconsistent and poorly-resourced, with long wait times that are detrimental to the long-term health and wellbeing of new parents and their babies.”
In the past two years, NHS England has been rolling out specialist perinatal mental health teams in every part of England. It has also increased the number of places in mother and baby units, which treat the most seriously ill women as inpatients, such as those with postpartum psychosis.
An NHS spokesperson said: “Women across England are benefiting from specialist perinatal mental health support, with an estimated 51,000 new mums treated over the last year, up nearly 70% compared to three years ago, with every local health system now having access to a specialist community perinatal mental health team.”
Although women with severe mental health symptoms such as psychosis or PTSD need professional help, a new study has found that the AI mental health app Wysa can help with prenatal and postnatal depression.
The study found that mothers who were highly engaged with the app saw a 12.7% reduction in depressive symptoms (from 15.8 to 13.8 measured on the Patient Health Questionnaire-9). Many who were highly engaged saw their scores drop from moderately severe depression to moderate depression.
The women who took part chatted with the AI chatbot about their emotions and stressors, expressing their concerns, hopes and need for support. They were also able to use the app to reframe their thoughts.
NHS England’s Long Term Plan promised to “transform” perinatal mental health services, introducing specialist teams in every region of the country so that by 2023/24, at least 66,000 women with moderate to severe perinatal mental health difficulties would be able to access care and support in the community. The care available would be extended from 12 months postpartum to 24 months postpartum. In practice, it seems, that promise has not been fulfilled. While the new teams have been established, a combination of staff shortages and under-resourcing means they cannot meet demand. As a result, pregnant women and new mothers with serious mental health problems are not able to access the care they desperately need. To fulfil its promise, NHS England needs to focus as a matter of urgency on retaining, training and recruiting staff with mental health expertise.