We hear from Ellen McGale, Perinatal Mental Health Project Manager at NHS England about plans to transform perinatal mental health.
More than one in 10 mums experience a mental health problem during pregnancy or within the first year of giving birth (the ‘perinatal period’). Some women might develop a serious mental health problem suddenly, even if they have no previous history of mental ill health, whereas others might find an existing condition is exacerbated. These issues are three times more likely to affect young mums (under 25 years) than older mums, perhaps in part because those falling pregnant at young ages often have endured adverse childhood experiences or isolation from family and friends. In recognition of this need, NHS England’s Five Year Forward View for Mental Health outlined plans to provide transformation funding to develop specialist PMH care to support an additional 30,000 women by 2020/21.
At the time of publishing, extraordinary variation in provision of care for women experiencing, or being at high-risk of, severe perinatal mental illness was identified (specifically, only 15% of localities in England had specialist PMH services that met national quality standards, and 40% of localities had access to no services at all). This year, we announced that by April 2019, pregnant and new mothers experiencing serious mental health difficulties will be able to access specialist perinatal mental health (PMH) community services in every part of the country.
Two waves of competitive bidding for transformation funding took place – the first in 2016 and second in 2018 – guided by input from a steering group comprised of experts by experience, clinicians, and representatives from relevant institutions. Services were funded based on compliance of their staffing models to national guidance and how well the service had considered the needs of their local population, such as by engaging in meaningful coproduction of service design. In addition to the community team expansion, beds in in-patient mother and baby units (MBU) are also growing, and in September the Rosewood MBU in Kent became the first of the four planned new 8-bedded units to start accepting referrals (availability at the unit, and all other MBUs across the country, can be viewed using WebBeds, developed by Wessex Clinical Network). Given the unprecedented transformation of PMH services (not just nationally, but globally) we were pleased to announce the publication of a set of PMH care pathways to support local areas to deliver evidence-based specialist services.
In 2017/18, an additional 7,000 women were seen in specialist community wave 1 sites alone – a significant overshoot of the target of 2,000 women in specialist services that year. While this is hugely exciting and service staff and commissioners should be thoroughly congratulated for their endeavours, these figures clearly demonstrate the extent of the unmet need that has existed for women across the country prior to these services mobilising.
There remains much to be done with the remaining two and half years of transformation funding to ensure services meet the full breadth of needs of mothers and infants during the perinatal period.
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