Meeting of the Parliament 17 May 2018
I, too, thank Clare Haughey, for securing the debate and the Maternal Mental Health Alliance for its campaign on perinatal mental healthcare and treatment. I thank all organisations that work in this important area and I thank my colleagues, whose contributions have been passionate and sensitive.
Like all members, I was glad to see a managed clinical network for perinatal mental health established, but it is clear that there is much more to be done.
Women are more likely to experience severe mental health problems following childbirth than they are at any other time in their life. Although we know that up to one in five women might experience some kind of mental health problem during pregnancy or in the first year of their child’s life, the mental health difficulties of too many women go undiagnosed and untreated.
Prioritising maternal mental health is a preventative approach to mental health; we know that the mental health of mothers, and new parents generally, is such an important factor in children’s development, wellbeing and their own mental health in later life.
In his review of national health service targets, Harry Burns advocated a “life course approach” to planning health services, which means acting more in early life to support people in the long term. It is about teacher training and training the early years workforce we are trying to attract.
Investment in maternal mental health is an investment in infant mental health. However, the support that we offer families at that crucial time is lacking, and the Royal College of Midwives has said that we are lagging behind England and Wales in making improvements.
It is concerning that only one health board in Scotland has a specialised perinatal community team that reaches the Royal College of Psychiatrists perinatal quality standards under the type 1 criteria. To be clear, in the view of the Royal College of Psychiatrists, failing to meet those standards is a threat to patient safety and rights and might even breach the law. As colleagues, including Annie Wells, have noted, although it is clear that very good work is going on in parts of Scotland, seven health boards offer no specialist community perinatal mental healthcare at all.
The Mental Welfare Commission has found that some women who would have benefited from specialist in-patient care in a mother and baby unit considered that the units were too far away from home—the travel and disruption to their wider family life was too challenging at a time when they were in severe distress. Therefore, we must think seriously about how to improve provision for women who are not close to Livingston or Glasgow. I know that the managed clinical network has been looking at that issue, and I would be grateful if the minister would address that point when she closes the debate.
Bliss has also stressed the need for better mental health support for parents whose babies are cared for in neonatal units. That is an incredibly anxious time for parents and they need access to psychological support.
The links between financial stress and mental health problems cannot be overstated. I very much welcome the new neonatal care fund to ease financial pressures for parents whose babies are in hospital.
We must also ensure that the basics are in place for all new families. Starting a family or having another child means huge change for most families’ financial circumstances. For those on low incomes, the prospect of long periods on statutory maternity pay, navigating the benefit system and paying for childcare can be frankly terrifying.
Parliament has shown the will to tackle child poverty. We have put targets to reduce child poverty back in place, and I am pleased that the Government has listened to the Green Party’s calls to roll out the healthier, wealthier children programme, which is an income maximisation approach that works.
In my Lothian region, family-friendly advice projects and healthy start projects are helping to boost the incomes of young families in Edinburgh and beyond. There have been other positive steps, too, such as the new best start grant. However, there is no room for complacency, because child poverty is predicted to rise, which will have an impact on maternal mental health. The Institute for Fiscal Studies predicts that nearly 30 per cent of children in Scotland will live in poverty by 2021. Such financial stress for parents can have a serious impact on their mental health.
I look forward to working with colleagues to improve perinatal mental health, and I look forward to the minister’s response to the challenges that we face in delivering that improvement.