Sadly, we know that maternal mental health problems continue to be the leading cause of maternal death in the first postnatal year.
The right care at the right time
Over the last five years, there has been investment in specialist perinatal mental health services across all four nations of the UK. This has resulted in new specialist service provision that supports women and families affected by the most severe and complex maternal mental health problems.
There are still gaps in specialist service provision that must be addressed, alongside this more commitment is also required to support the larger number of women who suffer with common perinatal mental health (PMH) problems like depression and anxiety.
Without access to the right care at the right time, the impact of common PMH problems can be long lasting and devastating for women and families.
An integrated model of care
In a new independent report commissioned by the Maternal Mental Health Alliance (MMHA), researchers from the London School of Economics and Political Science (LSE) estimate the costs and benefits of addressing unmet common maternal mental health needs.
The LSE report examined the economics of an ‘integrated model of care’ that would see mental health care for common mental health problems integrated into maternity and health visiting services. This would allow for women’s mental wellbeing to be accurately assessed at every routine contact and suitable advice, support and treatments to be offered – in a similar way to physical conditions such as diabetes or high blood pressure.
Researchers conclude that changes to standard practice could have a net economic benefit of £490 million over ten years; £52 million in NHS savings and quality of life improvements worth £437 million.
In contrast, the report finds that current practice leaves many women without access to evidence-based treatment when and where they need it.
Under the proposed model, health visitors, midwives and mental health practitioners would receive specific training and are employed to offer tailored support for women’s mental health alongside supporting them and their baby with their physical health and wellbeing.
If implemented this integrated service provision model would have the potential to strengthen existing provision by ensuring that all women are asked at every opportunity about their mental health and are then promptly offered low-intensity evidence-based interventions to support good mental health and wellbeing if they feel stressed, anxious or depressed or have other common mental health problems.
Addressing inequalities
The report measures the resources needed to provide this model of care against their economic return. The combined cost of this model across the UK, equates to £124 million a year, which would be a cost of £6 million per year for Wales.
Costs include training for midwives, health visitors and mental health practitioners, and the costs of employing them.
For this model to be effective, it must also address existing inequalities in women’s experiences of maternity and mental health care. It will therefore be vital for integrated service provision to be developed in an equitable way, actively seeking to meet the needs of all women.
This research provides an exciting blueprint for a realistic and cost-effective solution that could improve the lives of so many women and families affected by maternal mental health problems across the UK – both in this generation and the next.
Read more
Read the report: The economic case for increasing access to treatment for women with common mental health problems during the perinatal period
Read the policy analysis: A sound investment