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Most of UK doesn’t provide vital perinatal mental healthcare

Much more must be done on improving access to avoid potentially fatal consequences

Louise Prime

Friday, 20 April 2018

Women in most areas of the UK are still unable to access specialist perinatal mental health services more than a decade after national guidelines said they should be available to all women who need them, according to the latest report from the Maternal Mental Health Alliance. The MMHA said more than one in 10 women develop a mental illness during pregnancy or within the first year after giving birth so these services are vital in saving lives – and the Royal College of Midwives warned that the postcode lottery of services revealed by MMHA’s report shows that much, much more needs to be done to avoid potentially fatal consequences.

MMHA has published UK-wide maps, created from data collected by the Royal College of Psychiatrists in 2017, that reveal a stark postcode lottery in provision of specialist perinatal mental health services. These show that for the UK overall, nearly one in four areas have no such provision at all. And although the number of areas coloured green on the maps (indicating that women and families can access treatment that meets nationally agreed standards) has increased since MMHA last reported in 2015, it said “it is unacceptable that so many women and their families still cannot access essential care”.

The Royal College of Midwives pointed out that the new maps show that:

  • Pregnant women and new mothers in 24% of areas of the UK (coloured red on the maps) still have no access to specialist perinatal mental health services.
  • In England 51% of areas are green on the map.
  • Just 28% of areas in Wales are green.
  • Only 7% of areas in Scotland are green.
  • And Northern Ireland currently has no green areas at all.

MMHA noted that NHS England has used new government money to develop specialist services; and the Welsh government has given money to local health boards who have rapidly improved services. However, in Scotland and Northern Ireland there has so far been no prioritised funding for specialist community services.

MMHA warned that in the most severe cases, untreated perinatal mental illness can be life-threatening for women – suicide is a leading cause of death for women during pregnancy and the first year after giving birth – and it is campaigning for all areas of need to receive the necessary funding to end the postcode lottery for specialist services. It has called for commitment at both national and local level to ‘turn the map green’ by providing lifesaving services for women and babies everywhere.

The RCM published last July its own report on maternal mental health, which also highlighted the need for better services. The College’s chief executive and general secretary Gill Walton said yesterday: “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.”

She went on: “There is an urgent need for governments to invest more in services for women suffering with pregnancy-related mental health problems. Every trust with maternity services should have a specialist midwife in post to enable women who are unwell to get the very best care and support they need.

“These updated maps highlight again that our services are still a postcode lottery and are 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.”

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