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Monday 21st May 2018

Shortfall in help for mothers

21st May 2006

21052006_motherandbaby1.jpgMental health charity Mind launched its 60th anniversary Mind week with a new report, 'Out of the blue? Motherhood and depression'. At least one in six women experience mental distress during pregnancy or after birth and 25 per cent of all maternal deaths are due to psychiatric causes. Mind’s survey reveals an alarming shortfall in services, failures in diagnosis and lack of treatment options for these women.

Mind asked women with experience of post- or antenatal mental distress about the care they had received. It found that:

  • 63 per cent of those women admitted to hospital were on general psychiatric wards, contrary to national guidelines.
  • over 2/3 of women had to wait a month or more for treatment, while 1 in 10 had to wait over a year.
  • 75 per cent of women were prescribed medication and less than 20 per cent were offered Cognitive Behavioural Therapy when they sought help.
  • 90 per cent of women attributed their problems in getting care to a lack of understanding by health professionals and poor advice and information.

Many health professionals caring for mothers have had insufficient training to distinguish between normal emotional changes and mental health problems, says Mind, adding that there is confusion over roles and responsibilities in managing this aspect of perinatal care.

Mind's report found a lack of treatment choice, with drugs often the only treatment available. Some women report waiting up to one to two years for cognitive behavioural therapy, despite six NICE guidelines recommending it as a key treatment for mental health problems. This is particularly important for mothers because of the impact on bonding and the potential dangers of drug use in pregnancy and during breast feeding.

There is also a shortfall in specialist services, with severe shortcomings in provision for perinatal care being at the root of many of the problems reported by the surveyed women. 75 per cent of England’s mental health trusts have no Mother and Baby Unit (MBU) or access to one and fewer than half have any kind of specialist perinatal mental health service, meaning that the type of care women received depended on a ‘postcode lottery’. Standards in MBUs also vary; the Unit can be just two rooms, without security opening out onto a general psychiatric ward with mothers reporting feeling unsafe. The number of beds range from just two to ten – so often women cannot get a bed on an MBU, even when there is one in their area.

Mind makes a number of recommendations for training, standards and level of facilities. Mind’s Chief Executive, Paul Farmer, said that emotional and mental distress can be devastating for mothers and their families and that "The gaps in knowledge, provision and care for these vulnerable women must be addressed now."

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