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Perinatal mental health on the RSM agenda

27 March, 2015

Perinatal mental health on the RSM agenda

‘Only 3% of clinical commissioning groups have a perinatal mental health strategy and 50% don’t want one’ was the stark comment from a London consultant perinatal psychiatrist this week (26 March).

Dr Liz McDonald, who is also a member of the NICE guideline development group on antenatal and postnatal mental health, was addressing delegates at the Royal Society of Medicine’s (RSM) Maternity and the Newborn Forum’s first ever whole-day meeting on mental health in the perinatal period.

Public Health England’s national programme manager for public mental health Lily Makurah went as far to say that some areas of the UK have zero input to mental health.

And Emily Slater, campaign manager for the Maternal Mental Health Alliance’s Everyone’s Business campaign, concurred: ‘We know what essential perinatal mental health care looks like, but we’re not doing it across the country.’

Emily went on to remind delegates of the price of ignoring the issue: ‘It costs £8.1bn for each year we don’t address perinatal mental health issues; the cost of taking action is estimated to be between £280m and £337m.’

And with at least one in 10 women developing a mental illness during pregnancy or within the first year following childbirth and seven out of 10 hiding or underplaying their symptoms, according to Emily, the size of the problem was apparent.

Most referrals of pregnant women to mental health services come from midwives, said Liz, who outlined some key considerations for all healthcare professionals.

‘We need to understand the variations in presentation and course of perinatal mental health illness.

‘We need to tailor our messages to the people we’re delivering them to,’ she said.

Liz also emphasised the role of a paper trail, particularly after birth and if a baby becomes unwell. She asked: ‘How many Red Books contain the types of medication a woman has had during pregnancy?’

The mental health of fathers wasn’t ignored on the day.

‘Between one in 10 and one in 20 men can experience perinatal depression’ was one of the opening remarks by the University of Leeds’ research fellow in maternal wellbeing and women’s health Zoe Darwin.

Despite these statistics, Zoe questioned the inclusivity of perinatal mental health services for fathers, asking: ‘Are we still focused on the mother/baby dyad?’

This, in turn, raised the issue of screening fathers.

She said: ‘NICE makes no mention of men in mental health assessment. Should we be screening fathers too? And should this be targeted or universal?’

But, according to Zoe, there is a lack of evidence around intervention for men with perinatal depression. ‘We are not in a position yet to make any recommendations,’ she said.

Further details about the next meeting of the Maternity and the Newborn Forum can be found on the RSM website.

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