NHS England pledges specialist mental health services for new mums in every part of the country

NHS England & NHS Improvement | The Perinatal Mental Health Care Pathways | May 2018

NHS England has confirmed that new and expectant mums will be able to access specialist perinatal mental health community services in every part of the country by April 2019. The second wave of community-perinatal is now being rolled out to areas of the country that are currently underserved; with full geographical coverage  anticipated.

This £23 million  funding forms part of a package of measures, altogether worth a total of £365m by 2021, to transform specialist perinatal services so that 30,000 additional women can access evidence based treatment that is closer to home and when they need it, through specialist community services and inpatient mother and baby units (NHS England).

The perinatal
Image source: england.nhs.uk

 

NHS England & NHS Improvement have published guidance to provide services with evidence on what works in perinatal mental health care, as well as case studies describing how areas are starting to make this a reality.

The full release can be read at NHS England 

The full guidance can be downloaded here

In the media:

BBC News Improved mental health care funding for new mums

The Guardian NHS to make perinatal mental health available across England

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Women in a quarter of the UK still can’t access vital maternal mental health services

New maps launched today by the Maternal Mental Health Alliance show that pregnant women and new mothers in a quarter of the UK still cannot access lifesaving specialist perinatal mental health services.

background-2410669_1920According to new data, pregnant women and new mothers in 24% of the UK still have no access to specialist perinatal mental health services. In its press release, the Maternal Health Alliance makes the point that in the most serious cases, perinatal mental illness can be life threatening: suicide is a leading cause of death for women during pregnancy and one year after giving birth.

With more than 1 in 10 women developing a mental illness during pregnancy or within the first year after having a baby, it is important women with the most severe perinatal illnesses have access to vital specialist services wherever they live. If left untreated these illnesses can have a devastating impact on women and their families.

Full press release: Women in a quarter of the UK still can’t access vital maternal mental health services

Full detail: UK Specialist Perinatal Mental Health Community Teams (2017 data)

Related: Women across UK denied mental healthcare around childbirth, say doctors | The Guardian

Extra funding for pregnant and new mothers’ mental health announced

NHS England has announced extra funding will be made available to improve the mental health of at least 3,000 pregnant women and those who have recently given birth.
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 A total of £23 million is available during wave 2 of the  Perinatal Mental Health community services development fund.

The funding is part of a major programme of improvement and investment supporting the ambition in the Mental Health Five Year Forward View that, by 2020/21, there will be increased access to specialist perinatal mental health support , enabling  an additional 30,000 women to receive evidence-based treatment, closer to home, when they need it.

From 2019/20  funding for specialist perinatal mental health community services will be allocated through clinical commissioning group baseline (CCG) budgets.

 This funding will see 30,000 additional women getting specialist mental health care, in person and through online consultations including over Skype, during the early stages of motherhood, by 2021.

Further information can be found on the NHS England website 

Aerobic exercise moderately reduces depressive symptoms in new mothers

Doing aerobic exercise can reduce the level of depressive symptoms experienced by women who have had a baby in the past year | British Journal of General Practice |via National Institute for Health Research (NIHR)

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This review of 13 studies showed that involving new mothers in group exercise programmes, or advising them on an exercise of their choice, reduced depressive symptoms compared with usual care. The effect was moderate but significant. Examples of exercise were pram walks, with dietary advice from peers in some studies. The benefits were shown whether or not the mothers had postnatal depression.

The NIHR reports that the evidence does have some limitations regarding its quality but is the best research currently available. This review should give additional confidence to health visitors and GPs to advise women that keeping active after birth can benefit their mental and physical health.

Further detail at NIHR

Full reference: Pritchett R V, Daley A J, Jolly K. Does aerobic exercise reduce postpartum depressive symptoms? A systematic review and meta-analysis. British Journal of General Practice. 2017;67(663)

Inpatient provision for children and young people with mental health problems

Education Policy Institute, July 2017

In a new report, the Education Policy Institute (EPI) has examined the state of child and adolescent mental health inpatient services in England. The analysis explores the latest evidence and NHS data on admissions, quality of care, staffing and capacity.

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Source: Education Policy Institute

 

 

 

 

 
The research highlights 5 challenges to raising standards in young people’s mental health provision:

Workforce shortages
Minimum standards not met 
Provision of beds
Young people in inpatient care
Young people are being left in hospital for longer than necessary due to a lack of community services

 

The paediatrician’s role in mental health

Mental health is increasingly acknowledged as an integral part of a paediatrician’s work. This article aims to cover six important areas that will be useful to the general paediatrician | Paediatrics and Child Health

In the first part of the article I will tackle: why mental health is an important part of paediatric care, what kind of mental health difficulties do children encounter and how should paediatricians initially approach emotional and behavioural problems? In the second part I will describe the emotional problems encountered in paediatric services, how to understand behavioural problems and how to manage both of these in paediatric practice. Practical approaches and advice are provided in each section.

Full reference: Davie, M. (2017) The paediatrician’s role in mental health. Paediatrics and Child Health. Published online: 28 July 2017

Very preterm birth not associated with mood & anxiety disorders

Do very-preterm or very-low-weight babies develop anxiety and mood disorders later in life? Researchers have concluded a study to answer this question | ScienceDaily

The team studied nearly 400 individuals from birth to adulthood. Half of the participants had been born before 32 weeks gestation or at a very low birth weight (less than 3.3 pounds), and the other half had been born at term and normal birth weight. They assessed each participant when they were 6, 8 and 26 years old using detailed clinical interviews of psychiatric disorders.

“Previous research has reported increased risks for anxiety and mood disorders, but these studies were based on small samples and did not include repeated assessments for over 20 years,”

Their results? At age 6, children were not at an increased risk of any anxiety or mood disorders, but by age 8 — after they had entered school — more children had an anxiety disorder. By 26, there was a tendency to have more mood disorders like depression, but the findings were not meaningfully different between the two groups.

This study is the first investigation of anxiety and mood disorders in childhood and adulthood using clinical diagnoses in a large whole-population study of very preterm and very-low-birth-weight individuals as compared to individuals born at term.

The team also found that having a romantic partner who is supportive is an important factor for good mental health because it helps protect one from developing anxiety or depression. However, the study found fewer very-preterm-born adults had a romantic partner and were more withdrawn socially.