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Welsh Government urged to act on Perinatal Mental Health

Chair of the Maternal Mental Health Alliance, Dr Alain Gregoire, has written to the Welsh Cabinet Secretary for Health, Wellbeing and Sport urging him to act on the recommendations of the recent report by the Children, Young People and Education Committee report into perinatal mental health.  A full text of Dr Gregoire’s letter is below:

16 November 2017

Mr Vaughan Gething AM

Cabinet Secretary for Health, Wellbeing and Sport

Dear Mr Gething,

RE: Children, Young People and Education Committee Report: Perinatal mental health in Wales.

On behalf of the Maternal Mental Health Alliance, a coalition of over 85 UK wide national organisations, I write in response to the recently published report, Perinatal Mental Health in Wales. We congratulate the Children, Young People and Education Committee on a thorough and considered response to such an important area of healthcare. In particular it is clear that the committee listened to the voices of women with lived experience of perinatal mental illness, and to the professionals who work in this field.

We would also like to congratulate the Welsh Government on the progress that has been made in Wales. It is excellent that the £1.5 million in new funding was found for specialist perinatal mental health services and that the money was delivered in a timely fashion to Health Boards. New services are up and running and new staff appointed, who are now delivering specialist care where previously there was none. There is therefore much to be celebrated but, as highlighted in the report, there remain serious gaps in perinatal mental health care that need to be addressed. We support all of the recommendations of the committee but we would like to highlight a number, which we believe are particularly important.

1. As recommended in the NICE guidelines, we believe a properly funded Managed Clinical Network in Wales, which builds on the success of the existing Community of Practice, would assure the efficiency and effectiveness of the pathway of care. We believe that this would underpin and support many of the other recommendations made, for example the need for sound data to be collected, including robust outcome measures.

2. We agree that the funding model for new services, while improving provision across Wales, has resulted in variation in provision and that further funding should aim to address the inequity in care available to women and babies between health boards. Consistent with our “Everyone’s Business” Campaign (http://everyonesbusiness.org.uk) we want to see Wales “turn the map green”, because we believe that all women and babies in Wales should have access to this essential care, irrespective of postcode.

3. We support the call for Mother and Baby Unit (MBU) provision for women in Wales: the current situation of women with severe illness either being admitted to an MBU in England if beds are available, or being forcibly separated from their baby and being admitted to a local adult mental health unit, is not acceptable. We recognize the particular challenges faced in Wales, not least due to rurality and geography but believe that solutions can be found. We also support the recommendation of the report for discussions with NHS England regarding provisions on both sides of the border that could serve populations on both sides of the border.

4. While MBU beds and provision of care for severe mental illness are clearly a priority, it is also vital that good mental health care is provided across all levels of severity and we therefore support the recommendations focussed on this. Training of all professionals who look after women in pregnancy and the postpartum is of great importance, and ensuring that all maternity and health visiting services have specialist perinatal mental health midwifes and health visitors is essential if we are to redress the longstanding and glaring lack of parity between physical and mental health care in maternity. Despite being frequently stated, it is often forgotten that mental illness is by far the most common major health complication of having a baby, and suicide always in the top 3 causes of maternal deaths, yet mental health is the only area of NHS maternity care without dedicated services.

5. Finally, it is important to recognize the role of 3rd sector provision, as an effective and efficient way of delivering information, education, self help and peer support in this area and we support the call for resources for this vital work.

We look forward to the response of the Welsh Government to this report and to women and families in Wales soon receiving world leading perinatal mental health care. Please be assured that the MMHA, and our members, will be very happy to assist in any way we can in supporting, informing and collaborating on improvements in perinatal mental health care in Wales. Please do not hesitate to contact me if you think we can facilitate this in any way.

Yours sincerely,

Dr Alain Gregoire

Chair, Maternal Mental Health Alliance