With news that funding for NHS Trusts in England to provide mental health services has decreased by more than 8% since 2010 (McNicoll, 2015), the announcement by the Government that additional funds will be given to mental health service provision is definitely welcome. During the pre-election budget, Chancellor George Osborne declared that an extra £75 million will be provided over the next 5 years to care for women who experience mental ill health during the perinatal or antenatal period. The Government hopes that this will help bridge the health gap between people with mental health problems and the general population.
At the BJM conference last month, Julie Jomeen pointed out that since 1997, suicide has been one of the top three causes of maternal deaths in the UK (Royal College of Obstetricians and Gynaecologists, 2001; Confidential Enquiry into Maternal and Child Health, 2007; Centre for Maternal and Child Enquiries, 2011). If these funds are correctly assigned, then this money could go some way to saving the lives of women and creating a better life for them and their families.
There is a wealth of evidence demonstrating that mothers who receive high-quality support throughout pregnancy and in the postnatal period will have a better future health for themselves and their children. There are significant long-term consequences for children whose mothers had perinatal depression. Pawlby et al (2009) found that in their small urban study, all the children who were depressed at 16 years of age had mothers who were depressed, mainly during pregnancy. They also found that the risk of depression for the 16-year-olds in the study who had been exposed to antenatal depression, was 4.7 times greater than for adolescents who were not exposed. Therefore, it is imperative that we break the cycle of mental health problems.
As with many diseases, early identification is key to successful recovery. However, it is all well and good being able to identify women who have, or are at risk of, mental health issues, but without a specialist service to refer these women to, they will not get better. A report commissioned by the Maternal Mental Health Alliance (MMHA) found that mental health service provision in the UK is a postcode lottery (Bauer et al, 2014). In 40% of England and Scotland, 70% of Wales and 80% of Northern Ireland, there are no specialist perinatal mental health service at all. Less than 15% of the UK has comprehensive provision and of the 211 clinical commissioning groups, only 3% have formal strategies in place for perinatal mental health (Bauer et al, 2014).
It is now up to commissioners to ensure that these disparities are eliminated and the money is distributed fairly and effectively in order for every woman to be able to receive the high quality individualised care she deserves, no matter where she lives.