More than 1 in 10 new mums in the UK will experience a mental health problem during pregnancy or the first year of their child’s life. Whilst postnatal depression is perhaps the best known, there are a range of perinatal mental health problems, which can occur in pregnancy as well as postnatally, and which also include anxiety, OCD, PTSD, and psychosis. For some, these problems will be relatively mild and transient. For others, they will be serious – perhaps even life threatening. For all, perinatal mental illness can cast a shadow over the important early experiences of motherhood, and can have potentially life-long effects on mums and babies.
Research shows us that the risk of perinatal mental illnesses is much higher – as much as three times greater – for teenage mothers. There are a number of reasons for this: Teenage mothers in the UK are more likely to have had adverse early life experiences that increase their risk of mental health problems. And the experience of becoming a teenage mother can be particularly difficult – so often accompanied by disapproval from family and friends, thwarted hopes and expectations, and isolation from peers.
Family nurses can play a valuable role in reducing the incidence and impact of perinatal mental health problems among the mums they work with. Through developing a stable, therapeutic relationship they can build mums’ resilience, self-esteem and coping strategies, which might, in turn, reduce the risk of anxiety and depression. And through their regular contact and trusting relationship with clients, together with the use of evidence-based screening tools, nurses are well placed to be able to detect the early signs of illness and ensure that mothers are referred quickly to an appropriate service to provide additional support.
Ideally, Family nurses should be part of a perinatal mental health ‘pathway’ of care for new mothers. Care pathways are processes to ensure that particular conditions are identified and dealt with in a timely, efficient and effective way. When care pathways for perinatal mental health problems are in place and working effectively, risks or problems are identified early, and women are referred to the most appropriate services quickly so that they receive the right support at the right time. These services might be community groups, GP, talking therapies, specialist mental health community services, or in patient care depending on a mother’s needs.
The Mums and Babies in Mind Project helps local service providers and commissioners to develop and implement effective care pathways for all women with perinatal mental health problems. We work in four areas of the UK (Blackpool, Southend, Haringey and Gloucester). But we also try to share our learning and experiences through blogs, reports and interactive tools. These can be found on our website.
Recently, we launched a mapping tool, which helps professionals to rate their services against national standards to identify strengths and gaps where more work is needed. This week, we begin our new Leaders’ Programme, a programme of learning and networking events for professionals who are well placed to drive forward system change for mums with mental health problems and their families. We are delighted that three family nurses are able to take part in this programme.
Working together to provide support
Mums and Babies in Mind is a Maternal Mental Health Alliance (MMHA) project funded by the Big Lottery. The Alliance is a coalition of over 80 national organisations – including the FNP National Unit - who work together to campaign for improvements to perinatal mental health services. This work is much needed. Despite the prevalence and recent high profile of perinatal mental illness, there are still shocking gaps. There is no specialist mental health service in more than 40% of areas in England, for example, and only 25% of women with postnatal depression get any treatment.
FNP recognises that if we are to improve the life chances of a baby, we must support his or her mother, from the earliest stages of pregnancy. Mums and Babies in Mind is based in the same philosophy: if we can prevent, reduce and/or manage mums’ mental health problems, we help her to give her baby the best start in life.
By Sally Hogg, Strategic Lead, Mums and Babies in Mind