Howard et al (2014) stated that ‘there is no time in the lifespan that the statement “there is no health without mental health” rings truer than in the perinatal period’. It is estimated that perinatal mental health conditions cost around £8.1 billion per year in the UK. This equates to just under £10 000 for every singleton birth in the country, and around 72% of that cost relates to the adverse impact on the child (Bauer et al, 2014). However, for decades, maternal mental health has been a neglected area, with a lack of specialist therapeutic support for mothers and babies. Compounded by the stigma that prevents many women from seeking help, alongside fears that admitting to struggling may cause a baby to be taken away, the result has been that ‘about half of all cases of perinatal depression and anxiety go undetected and many of those which are detected fail to receive evidence-based forms of treatment’ (Bauer et al, 2014). With the rising demand and growing waiting lists created during the COVID-19 pandemic, this number is now likely to be much higher.
About MumsAid
MumsAid is a multi-award winning charity founded on the belief that early identification of perinatal mental health difficulties is critical and that support should be non-pathologising and easily accessible to all who need it. The charity was started in 2012 by a psychotherapist (MumsAid CEO, Dr Miriam Donaghy) who wanted to address the dearth of services that she observed. Since then, the charity has endeavoured to meet the perinatal mental health needs of women in southeast London, and has to date supported over 5000 women. The extensive programme of support, available both antenatally and postnatally includes:
- Free, accessible counselling and psychological therapy based on the proven structure, themes, approach, resources and knowledge (STARK) model
- A specialist package of support for teenage mothers (YoungMumsAid), which includes counselling and longer-term psychotherapy, weekly groups, advocacy and practical help such as the provision of nappies and baby clothes
- Trauma therapy service, including eye movement desensitisation reprocessing for those who have experienced a traumatic birth, and a psychoeducational group
- A partnership service with The Motherhood Group (CIC), providing counselling specifically to support black and minority ethnic women with their perinatal mental health needs
- Mighty Acorns, a programme of support for mothers with babies born with disabilities or medically-complex needs, which provides a weekly drop-in, WhatsApp group and home-visits
- A weekly art group and other wellbeing groups
- A 24-hour text service for online counselling and out of hours support
- A private counselling service available in the evenings and online (50% of fees fund MumsAid to provide free services)
- Befriending by trained peer volunteers
- Training in perinatal mental health awareness for frontline staff.
The charity supports mothers with a broad spectrum of perinatal mental health issues, including anxiety, depression, intrusive thoughts and post-traumatic stress disorder but emphasise that a clinical diagnosis is not required to receive support.
How MumsAid works
MumsAid offers a pragmatic, relational and trauma-informed model of counselling, known as STARK, which was devised by MumsAid's CEO, based on her knowledge and experience of developing perinatal support over more than 20 years. The acronym refers to the structure, themes, approach, resources and knowledge that underpin this effective model, but also relates to an understanding of the importance of acknowledging some of the ‘stark realities’ of the transition to motherhood alongside the positive lens through which it is usually viewed. The STARK model aims to alleviate mental health difficulties, improve emotional wellbeing, mother-infant bonding and confidence in parenting ability, reduce social isolation and strengthen support networks. This in turn helps to reduce any potential negative impact on babies' development from having a mother who is struggling.
A 12-week programme of counselling is provided by trained, experienced volunteer therapists who have a special interest in perinatal work, sometimes because of their own personal lived experience, making it a particularly cost-effective service. Two follow-up sessions are offered at 3 and 6 months. The flexible approach offered can be adapted to meet the individual needs of mothers and babies and is available to women who are either pregnant or have children under the age of 2 years. Women may self-refer or be referred by other professionals involved in their care. MumsAid has developed strong relationships with local children's centres, midwives, health visitors, GPs and social workers, to ensure that fewer women are left unsupported. MumsAid also accepts referrals from the local NHS perinatal mental health team and the improving access to psychological therapies services.
The STARK model allows for adaptation for specialist, targeted services to extend the length of support, such as in the Mighty Acorns project and YoungMumsAid, a more holistic, wraparound service for 16–21 year olds, offering practical help as well as up to 6 months of counselling. Advocacy workers who can offer home visits complement the support from senior psychotherapists, who are able to manage the complexity, higher support needs and child protection issues often involved with these mothers.
MumsAid offers therapeutic support from children's centres and community centres to help engage marginalised women and, wherever possible, crèche places for babies are provided to ensure that lack of childcare does not prevent mothers from receiving support. During the pandemic, MumsAid was able to swiftly move its therapeutic services online (including the art group) and is now offering a mixed method of delivery with some women choosing to access services in-person while others prefer to access via an online platform, such as Zoom.
The impact
MumsAid's counselling service has been proven to be effective in reducing depression, anxiety and stress levels, improving mothers' confidence in parenting and enhancing relationship quality. An external service evaluation (McPin Foundation, 2020) has shown that 85% of mothers completing counselling moved below the threshold for depression. The service was also shown to be successful in reaching mothers who might not otherwise engage with statutory support services; 56% of women who received counselling were from black and minority ethnic groups. All women who used the service said that they would recommend it to others.
‘I can't recommend MumsAid highly enough - it was a lifeline when I really needed it and I'm so thankful and impressed by the work you do. I feel so much happier, more connected to my daughter’ Lisa, mum of 6-month-old
Looking ahead
The last 2 years have seen an increase in the prevalence of mental health problems such as anxiety or depression during the COVID-19 pandemic, and this appears to be even more acute for perinatal women, with a far greater number reporting that they have had a traumatising experience.
Although there has been an increased awareness of the significant public health costs of poor perinatal mental health for mothers and their families, reflected in the current NHS (2019) long term plan's focus on increasing access to high-quality perinatal mental health care from preconception to 24 months after birth, there is still much more to do.
MumsAid celebrates its 10th birthday this year and wants to use this milestone to continue raising awareness, but also to expand what it is able to offer to meet the growing demand for maternal mental health services. The hope is to share the experience and knowledge of what works with others, and by offering more training to therapists and health professionals, to build a network of MumsAid therapists across the country so that they can provide effective, compassionate support to mothers during this critical stage in their lives.