Units needed to fight baby blues Women can experience mental health problems during and after pregnancy. Here, the Royal College of Nursing explains what Wales needs to do to support both mum and baby
Mental health problems experienced by women during the period from the start of pregnancy to the end of the first year their baby is born are often referred to as perinatal.
Such problems include a variety of psychiatric and emotional disorders which can vary in severity.
They can range from mild to moderate anxiety and depression, to more severe depression and, less commonly, to more major mental illness.
Perinatal mental illness of some degree can affect up to 20% of women.
Without appropriate treatment and support for those affected, perinatal mental health illness can lead to significant and longlasting effects on pregnant women, new mums, their children and their families.
Services that aim to tackle perinatal mental illness not only seek to prevent the onset of problems and restore and enhance the emotional wellbeing of the pregnant woman, but also seek to support the woman’s children, her partner and her wider family.
When comprehensively provided, such services are concerned with the prevention, detection and management of perinatal mental illness.
Services should provide evidencebased interventions that are predominantly delivered within the mother’s home or as close to her home as is possible.
They should aim to ensure that while receiving care and support, mothers and their babies are not separated.
This is especially important when, in exceptional circumstances, a mother may require a hospital admission to a mental health unit.
Nurses, midwives and health visitors throughout the healthcare system in Wales have key roles to play in promoting the mental health and emotional wellbeing of pregnant women and new mothers.
Such professionals also provide the backbone of general health and social services and specialist services that are established to support women experiencing perinatal mental illness. NHS perinatal mental health services in Wales are delivered within the context of two key strategic frameworks.
They are Together for Mental Health, and The Strategic Vision for Maternity Services.
In recent years the Welsh Government has given impetus to the improvement of the specialist perinatal mental health services it oversees.
In 2016 it provided an additional £1.5m to support the further improvement of specialist perinatal mental health services across Wales.
This money is being used by health
Pboards across the country to improve the prevention, detection and management of perinatal mental illness in the communities they serve.
One of the criticisms of perinatal services in Wales, levelled by many service stakeholders, is that we lack a dedicated inpatient perinatal mental health unit that is located in Wales.
Such units provide specialist inpatient care for mothers with severe perinatal mental health problems, and they do so in such a way that mothers are able to be cared for while staying with their babies. There used to be such a unit in Wales, but it closed in 2013. Since then mothers experiencing perinatal mental illness who require inpatient care have had two options.
They can either be admitted to a general mental health unit in Wales (without their babies), or they can be admitted with their babies, many miles from home, to one of the specialist perinatal mental health units in England. Neither situation is desirable. In April this year the Children, Young People and Education Committee of the National Assembly for Wales undertook an inquiry into perinatal mental health in Wales.
It sought to review how services across Wales are being delivered, with the aim of making recommendations for improvements.
The committee’s report on the inquiry is awaited.