Sunday, 10 January 2016

£290 million

This morning, David Cameron announced a huge injection of cash into mental health services. (http://bbc.in/1RvwrDg)

Included in a package of almost £1 billion is a sizeable £290 million (spent over the next four years) to provide specialist care to mums before and after having their babies.

This money is welcome, it is significant, and it could make a real difference to the 1 in 5 mums who suffer mental ill health during the perinatal period.  However.  Government hasn't got a great track record when it comes to protecting mental health services and in fact seem to have done their best to belittle and diminish what patchy care there is.  

But let's let bygones be bygones.  Here's a real chance to get it right. If they were to ask me, where would I tell them to spend it?

1. Perinatal mental health midwives in every maternity service.
This is the first decision I would make: to recruit, train and commission enough specialist posts to cover the entirety of the UK's maternity system.  These midwives would have time to care for the most at-risk, distressed and struggling pregnant women and new mums.  They would provide special antenatal and postnatal classes to women in their care, as well as being a continuous point of contact in each mum's care pathway.  They would also be a first point of call for psychiatric emergencies in the pre and postnatal period. 

2. Mandatory perinatal mental illness module included in all midwifery, health visiting and general practice training schemes.
All healthcare professionals likely to be in contact with pregnant and postnatal women will have undergone a minimum training in perinatal mental health.  The aims of the training are to increase awareness of different mental illnesses, how to signpost to the correct sources of support, and how to provide immediate support and reassurance. 

3. Mother and Baby Units in every region of the UK.
At last, here is a chance to close the gaps and end the postcode lottery of perinatal mental health services.  Let's stop closing down MBUs (unit numbers have fallen from 22 to just 16 in recent years, with more under threat).  Let's protect and nurture those units we have. And let's open much needed new MBU beds in regions such as the South West, Wales and Northern Ireland.

4. Enhanced therapeutic programme for all perinatal services (inpatient and community).
This is the ultimate "Nice To Have" in perinatal mental health care.  Psychiatrists are a wonderful breed who can do remarkable things with illnesses of the brain.  But they aren't miracle workers.  Recovery from severe mental illness, or living well with an enduring mental illness, takes guts.  It takes tenacity, ingenuity, creativity.  Everything and anything should be considered, depending of course on the individual. I would like to see a non-neglible portion of funds set aside for grant-making programmes for local sources of support:  walking groups and buggy fitness for mums and dads, group mindfulness therapy, art and drama therapy, parent-infant therapy, and (especially) high quality peer support.

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