A few findings that might interest some of you, mainly from a report carried out by the London School of Economics and the Centre for Mental Health that was published last month:
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One in five women develops some form of mental health issue during pregnancy and the months after childbirth.
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For all births in one year, there is a long-term cost of £8.1bn stemming from mental health problems. (And the report's authors say this is a conservative estimate). Of the £8.1bn cost, a fifth was borne by the public sector including the NHS and social services. The remainder was estimated as a wider cost to society such as through lost earnings.
To put that into perspective the cost to the UK economy of overweight and obesity was estimated at £15.8 billion per year in 2007, including £4.2 billion in costs to the NHS.
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There are significant gaps in the detection of mental health problems in the period before and after birth, with only an estimated 40% being diagnosed, with just 3% of women experiencing a full recovery
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The cost of providing a service that met minimum National Institute for Health and Care Excellence guidelines across the country would be £337m a year.
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Of 211 clinical commissioning groups in England, the regional organisations that partly replaced primary care trusts last year, just 3% have a formal strategy for perinatal mental health services, with a significant majority having no plans to implement one.
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Talking therapies are seen as especially useful for milder cases of perinatal depression since many anti-depressants cannot be used while pregnant or breastfeeding, but there is currently capacity to treat just 15% of women in England who need such services.
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Women can be treated in special mother and baby mental health units, but twice as many of these facilities are needed.
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The Maternal Mental Health Alliance carried out a parallel audit of perinatal mental health services around the country with the Royal College of Psychiatrists.
It found no specialist service at all in 40% of areas in England and Scotland, rising to 70% on Wales and 80% in Northern Ireland. Fewer than 15% of the UK had comprehensive provision.
- There is very wide disparity in care throughout the NHS which is highlighted by London; seven of the 32 areas had highest-level services, but nine provided none.
I personally benefitted massively from an amazing ante-natal mental team. But I had to go to a neighbouring Trust to get that and it was something that I actively sought out off my own back. When I have dealt with mental health services in my own Trust as part of my maternity and postnatal care they do not have specialist services and have been poor in comparison as a result.
People are pointing the finger on this thread about breastfeeding, but that misses the point massively. That type of pressure which may or may not have been a contributing factor in this particular case, is the result of poor understanding of mental health in general. The real issue as I've detailed above is the massive, totally inexcusable under investment in peri-natal mental health which means staff are not trained to prevent or spot problems nor do they gave resources to help women if they are picked up on. If staff understaff issues better then care all round would be better and there would be more understanding of pressuring women in a variety of situations during and after birth.
I hope no one thinks I'm jumping on the bandwagon of this poor woman's death, but it does seem clear that there was some sort of failure here which relates to her mental health, simply because women don't just walk off a ward like that, if they are well. I don't see the point of pointing fingers at the staff on wards, when the heart of the issue clearly lies at a funding and political level.
We do not need to security tag babies or lock pregnant / postnatal women with mental health problems up. We need services and staff who can support them, we need women to be aware of services that can help them, and we need to remove the stigma and fear that women have if they have mental health issues.
The MMHA launched a campaign last month to highlight the issue. maternalmentalhealthalliance.org.uk/ They published a map which shows which areas are performing better than others, which can be found here: everyonesbusiness.org.uk/?page_id=349