One in five women experience a mental health condition during pregnancy, or in the year after giving birth. It can affect any woman.
And it can be devastating. The deaths earlier this month of Charlotte Bevan and her four day old daughter Zaani, are a tragic reminder of just how much further we have to go to ensure that all mothers with mental illness get the help and care that they need. The coroner is currently examining whether the hospitals involved in their care applied guidelines on the treatment of mothers with mental health issues.
But regardless of the outcome, women across the country are already being failed by the system we have in place. New guidelines published by NICE highlight the serious gaps in care for women who experience mental illness before, during and after their pregnancy. It shows that too many women and their babies are being badly let down at an extremely vulnerable time in their lives.
On top of this, research released recently from the Centre for Mental Health and London School of Economics (LSE) shows that untreated mental illness among women before and after they give birth is costing our economy £8.1bn every year. Nearly three-quarters of this cost relates to the impact on the child and not the mother.
I recently visited London’s Bethlem Royal Mental Health hospital, and met several mothers who had been admitted along with their newborns. They came from all walks of life. One had worked in the City, one as a health economist, one a teacher: all had experienced acute mental illness, from severe depression to psychosis.
One woman, called Fiona*, told me that she was catatonic, delusional and hallucinating when she was admitted. She couldn't recognise her family or even her baby. Another mother called Jo told me she was admitted after two suicide attempts, and was confined to bed for six weeks. Two years later, she now feels like she's won the lottery every day, thanks to the care and treatment she received at the Bethlem.
The support the women and their babies receive at the unit is amazing. Yet this is not the experience of all new mothers with mental health problems.
Almost half of all cases of mental illness among women before and after they give birth go undetected. Many of those who are detected do not get the treatment they need. To get the type of specialist support offered at the Bethlem, a woman’s condition usually has reached crisis point. One woman told me after being sent home from A&E, she was only referred to the Bethlem when she started to feel as though she was going to kill herself and her baby.
The provision of specialist mental health services in this country is shocking. The Bethlem is one of only seventeen specialist mother and baby units across the country and many women have to travel for hundreds of miles to get to one.
One woman I met at the Unit was from Dover, and her family were travelling over two hours to visit. Half of women have no access to a specialist service and are either placed on an adult psychiatric unit, separated from their partner and baby or don’t receive any specialist help at all.
In order to really give mental health the focus and attention it deserves, we need to bring together and integrate all the services that provide women with the care they need. This includes the mental and physical health services, as well as social care.
We need to do more to raise awareness of perinatal mental health illness and address the stigma that still surrounds it in our society. I can't think of any mother who would think twice about discussing the changes that happen to their body during pregnancy. But on top of this, we need to reach a point where they're comfortable talking about what might happen to their mind.
*some names have been changed
Luciana Berger is Shadow Minister for Public Health
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