Women’s lives are being put at risk by substandard mental health care during their pregnancy and in the first year after childbirth in most parts of the UK, a report has found.
About one in every five women develops a mental illness at some point during the perinatal period, the stage from pregnancy up to a year after giving birth. However, none of the health and social care boards in Northern Ireland or Wales met the national quality standards created by the Royal College of Psychiatrists’ Perinatal Quality Network (PQN).
Maternal deaths due to mental health problems are also increasing, with maternal suicide being the lead cause of deaths in the first year after childbirth. Despite this, the report by the Maternal Mental Health Alliance (MMHA) found that many specialist perinatal mental health services do not receive adequate attention or investment, or meet the quality standard of care.
The minimum standard of care that women, babies and families should receive is defined as PQN standards type 1. In England, only 16% of the specialist perinatal mental health community teams met these standards.
Teams are assessed on seven key areas in delivering care, including criteria for patient care plans, the minimum number of consultant perinatal psychiatrists per 10,000 births and instructions on the discharge and transfer of care.
Two out of 14 Scottish health boards met PQN standards for type 1, and there was inadequate provision in remote areas such as Orkney, Shetland Islands and Western Isles.
Alex, who did not receive adequate specialist care during her perinatal period, said: “My journey would have been so much better if I’d had access to specialist perinatal care and a mother and baby unit. My treatment was completely derailed by my separation from my son.”
The report, which analysed data from 70 NHS trusts across England, Wales, Scotland and Northern Ireland, said that while overall provision and quality of services has improved, with many areas increasing their budgets, women still face many risks as local areas anticipate an underspend, which affects the accessibility and quality of care.
Over 2020 to 2021, the overall budget allocated to specialist perinatal mental health services across the UK was £83,648,546. However, only £74,285,606 of that was spent. In 2022 to 2023, the budget allocated increased to £135,737,671, yet the projected spend is only £120,119,199.
The most common reason given for the underspend was workforce challenges, such as insufficiently resourced teams, made worse by unclear or late allocation of funds.
One healthcare 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.”
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