‘Someone must take responsibility for turning the perinatal mental health rhetoric into reality’

By Sally Hogg

This week’s Health Select Committee report on CAMHS recognised the perinatal period as a “crucially important” time for promoting good mental health, but found “unacceptable variation” in services.

The foundations for mental health are laid in pregnancy and infancy. During pregnancy, a mother’s emotional wellbeing can influence a baby’s developing stress response and after birth the interactions between children and their parents shape brain development.

It is never too late to improve a child’s mental health but, as always, prevention is better than cure. It is easier, cheaper and more effective to intervene early in a child’s life than trying to fix things later on. Because of the rapid development in the perinatal period, the impact of experiences positive or negative is greatest during this time.

Despite pregnancy and infancy being critical times for mental health, services often focus only on mothers’ and babies’ physical health and neglect their emotional wellbeing. All too often, services don’t attend to a child’s mental health until they exhibit problems later in life.

Whilst some children experience early adversity and go on to achieve their full potential, others will not. The impact of early problems are worse if a child experiences a number of different risk factors, such as parental mental illness, poverty, neglect and abuse at the same time.

Research shows that children who experience six or more of these risk factors face a 90-100% likelihood of having one or more delays in their cognitive, language or emotional development. But these problems are all preventable if families get the right help and support at the right time.

At the NSPCC we have made pregnancy and infancy a priority.

Our work involves developing and delivering evidence-based services such as antenatal education. We have also worked with local authorities to improve their understanding and management of the risks facing babies from pregnancy onwards. Next year we will introduce a new service to improve parental mental health in pregnancy.

But we can’t solve this problem on our own. The whole system needs to recognise and respond to the importance of mental health during this important life stage.

The health committee report states that service specifications must make clear what perinatal and infant mental health services should exist in every area. However, there is already widespread consensus about what good provision looks like, supported by NICE guidance.

The big question is who is responsible for ensuring these standards are met?

There is still a lack of clarity about who is accountable for providing these services. Perinatal and infant mental health care falls through the gaps between adult mental health services, CAMHS and maternity care.

At a national and local level there must be clear ownership for tackling these issues. MPs and ministers may all agree that this is a problem that must be fixed. Someone must now take responsibility for turning the rhetoric into reality.

Sally Hogg is development manager at the NSPCC