Call for overhaul of mental health services for new mothers

New mothers with severe and complex mental health needs are being “failed” by the State, according to the National Women’s Council (NWC), which is calling for the strengthening of specialist health services.

A report from the NWC published on Tuesday highlights shortcomings in perinatal mental health services in Ireland.

The time limit on services provided after giving birth, and the separation of mothers from their babies when inpatient treatment is required, are identified as two issues of particular concern.

Maternity care services typically end six weeks post-partum and are designed with the assumption that physical health concerns are resolved by then.

However, anxiety, depression and other complex mental health disorders increase three months after birth and were the highest at six months post-partum, according to Trinity College Dublin’s Maternal Health and Maternal Morbidity in Ireland study.

While depression and stress dropped slightly at nine months, another increase is seen again at one year post-partum, the study found.

One in five women experience mental health difficulties during the perinatal period.

The NWC is calling for a more comprehensive perinatal care system that would allow women to address both physical and mental health concerns throughout the first year of motherhood.

This is alongside the urgent establishment of a specialist mother and baby unit, a key aspect of the specialist perinatal mental health service model of care published by the HSE in 2017.

Mothers who have severe or complex needs are admitted to general mental health units without their babies, which the NWC argues has an adverse effect on the mother-infant bond and attachment.

“This is why NWC has repeatedly called for the urgent establishment of a mother and baby unit. Women cannot wait any longer,” said Doireann Crosson, women’s health co-ordinator at NWC.

“We are also calling for the strengthening and resourcing of all specialist perinatal mental health services, as well as supports at primary care level and in the community, recognising the increasing demand and pressure on existing services.”

Migrant and Traveller women do not feel represented by the data which underpins perinatal mental health policies and services, according to participants in a round-table discussion for the report. This is despite the prevalence of mental health difficulties being far higher among Traveller women.

Salome Mbugua, chief executive of Akidwa, the national network of migrant women said migrant women have different experiences in maternity services, yet the absence of specific data and research “means our experiences are made invisible.”

“We know from small-scale research and from the UK that maternity outcomes for migrant women are worse than for the general population. We need better data on the experiences of migrant women to improve perinatal mental health services for all women, underpinned by practices of cultural humility, gender sensitivity and trauma-informed care,” she said.

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