- Postcode lottery in England puts mental health of expectant and new mums at risk with many areas not treating all women who need help
- The Royal College of Psychiatrists is calling for funding for perinatal mental health facilities in the next spending review and for local health bodies to invest in services in their areas
Thousands of women could not get vital help with their mental health during pregnancy or right after giving birth because of the covid pandemic, according to new analysis using the Royal College of Psychiatrists’ Mental Health Watch.
In 2020/21 47,000 were expected to access perinatal mental health services, but in the most recent data for the 2020 calendar year only 31,261 managed to get help with problems such as anxiety, depression, post-traumatic stress disorder and suicidal thoughts in pregnancy and early motherhood.
Lack of support for mental health problems during and after pregnancy can have serious consequences for parents, children and their families.
The pandemic was not the sole reason the mental health of thousands of women was overlooked.
Variation in care across the country due to lack of local investment in perinatal mental health services means that in many areas in England many pregnant women and new mums can’t get mental health support.
Dr Trudi Seneviratne, Registrar of the Royal College of Psychiatrists who works in perinatal mental health, said:
"Funding need is urgent"
“Many women can develop mental health problems for the first time during pregnancy and after birth, or are at risk of pre-existing illnesses made worse if they don’t get the right support in time.
“Staff in perinatal mental healthcare have made every effort to support women in these extremely challenging times but services have been under unprecedented strain. Funding for mental health facilities is long overdue but is more urgent in the face of the Covid-19 pandemic.
“Gaps in local funding in certain areas in England should be urgently addressed so that the same standard of care is available to all women, no matter where they live.”
The Royal College of Psychiatrists is calling for funding for perinatal mental health facilities in the next spending review. This new investment will mean more women needing support can be treated, and that the mental health estate is fit for purpose, with suitable and welcoming spaces that can contribute to patients’ recovery.
End the postcode lottery in maternal mental health
Psychiatrists are also calling on local health bosses in certain areas to address longstanding funding issues and put an end to the postcode lottery in maternal mental health.
Perinatal mental health support was broadly on track before the pandemic. In 2019/20, 30,625 women accessed perinatal mental health services, against the expectation of 32,000 outlined in the NHS Long Term Plan.
Disruptions to care combined with the stresses of the pandemic exacerbated poor mental health in expectant and new mothers and made it harder to get diagnosis and treatment.
In all local areas in England at least 7.1% of pregnant women and new mums are expected to need support by mental health services. North Central London is the worst performing area in the country with just 150 out of 1,521 pregnant women or new mothers expected to access specialist support managing to get it. By contrast, in West London 250 women accessed support even during the pandemic, exceeding the expectation of 181 set by the NHS for that area.
Up to 1 in 5 women have mental health problems in pregnancy or after birth and two thirds of women will hide or underplay their illness.
When Leanne developed depression after she had her first child five years ago she felt deeply ashamed and was worried that people would judge her. It was only after she wanted to take her own life that she found the courage to seek help from her perinatal team and received treatment to recover.
Leanne fell ill again with depression right after she had her second child but disruption to services as a result of the pandemic made it harder for her to get well.
34-year-old Leanne said: “Covid hit when my daughter was five months old. I didn’t have support with childcare as neither nursery nor family support were available at the time. Everything I had to help me as a new mum pre-pandemic I couldn’t lean on anymore.
“I struggled with the concept that there was no end in sight. Struggled to find any positives in anything.
“Having been through this before, I knew I had to get help this time around. But there are so many parents out there who feel that they’re not good enough if they ask for mental health support during what’s meant to be the happiest time of their lives.
“It’s funny how we expect help for our physical health without thinking about it, but not for a mental illness. We need to change that culture and make sure that services are there to support everyone who needs help before they reach crisis.”
Now Leanne has set up a charity in Warwick to raise awareness of perinatal mental health and gave up her career as a solicitor to become a mental health nurse so that she can help women going through the same.
Produced by the Royal College of Psychiatrists, Mental Health Watch uses public NHS data to track how well the mental health system in England is performing