By Beckie Lang, Health Campaigns Manager
While every NHS service costs money, the report shows for the first time how much it costs when we don’t provide those services – and reveals the comparatively small amounts needed to give women the help they need when they need it.
The analysis, carried out by the London School of Economics and the Centre for Mental Health, shows that inadequate provision of pre-and post-natal mental health services is costing the nation more than £8 billion a year. Without the right treatment at the right time, there is a snowball effect which impacts on our economy in many ways – from lost working days to support needed for our children. In comparison, only £337 million a year is needed to get our mental health services up to scratch.
The current state of mental health care
So what do we mean by up to scratch? Well, right now, 40 percent of localities provide no care at all. And just 15 percent offer specialist services for women with existing, more complex mental health problems such as bipolar disorder.
Mental health problems for new mums often have their roots in pregnancy. However, research from Tommy’s and a group of other specialist organisations has shown that not only are services often unavailable, pregnant women’s signs and symptoms aren’t getting spotted at all.
Fears around disclosure are the first stumbling block. Three quarters of women we surveyed with depression and anxiety never fully revealed their feelings to a health professional, for reasons ranging from embarrassment to fear that their baby would be taken away from them (Perinatal mental health - the experiences of women and health professionals)
To add to the problem, nearly half of midwives told us that there was no time in appointments to talk about emotional wellbeing. Many also felt that they didn’t have the information they needed to identify and discuss mental health issues.
A holistic approach to emotional health in pregnancy
Expecting a baby is an emotional journey as well as a physical one, and at least one in ten women will experience depression, anxiety or both during their pregnancy. As it stands, physical and mental health are too often considered separately in isolation. We need to take a much more holistic approach to pregnancy care, including discussions of emotional health in check-ups from start to finish. We then need to make sure that midwives have the right tools for spotting women at risk and the appropriate services are there to treat them.
Some of these changes are already in progress. Last year, together with Netmums, the Royal College of Midwives and the Institute of Health Visiting, Tommy’s launched The Wellbeing Plan to help midwives discuss mental health and plan support approaches for women for use during their pregnancy and in the first few weeks after birth. The Maternal Mental Health Alliance is working with the Royal College of Midwives to look in more detail at the role of specialist mental health midwives, funded by the Department of Health.
Our own resources at Tommy’s are also undergoing a review so that our mental health information sits side by side with the rest of our advice on pregnancy health. We want to women and their families to be as comfortable talking about their emotional wellbeing as they might be about elements of their physical health during pregnancy. Spotting signs of changes in our mental and emotional state like persistent low mood or irritability are as important as spotting the more familiar physical warning signs such as bleeding or pain.
It’s only by addressing these shortfalls that we can really start giving pregnant women everywhere the care and treatment they need. And as today’s report shows, it’s not only mums that will reap the benefits.
Our information on mental health in pregnancy can be accessed here
Health professionals need to be better trained in helping couples to cope with the loss of their baby.
Jo went into labour at five months and lost her triplets. Six years later, she’s finally coming to terms with her grief.
Aruna suffered two miscarriages between April and October 2011. She now has two sons.
Mark and I have two girls. We also had a son, Alexander, but he was stillborn at 36 weeks.