Meeting of the Parliament 17 May 2018
I, too, thank Clare Haughey for bringing forward this debate on what is a really important subject.
Why is perinatal health everyone’s business? The latest statistics suggest that everyone will know someone with experience of perinatal mental health problems, be it a mother, sister, aunt, cousin or friend. Our future is vested in the wellbeing of children and, therefore, in the wellbeing of their mothers. There is a saying that it takes a village to raise a child, and that sentiment is particularly important with perinatal health. Is it, therefore, really acceptable that seven out of 14 health boards in Scotland offer no specialist care?
At present, without specialist perinatal services, it falls to GPs to detect signs of maternal mental health problems. However, how can we expect a doctor to identify and treat the often well-hidden symptoms of mental health issues, which are frequently those of an individual whom they have never met before? I know from personal experience how important a well-established relationship with one’s GP can be in identifying when something is not right. After a routine visit to my own GP following the birth of my fifth child, she asked me, as I was preparing to leave, how I was feeling. My initial, quick response of “Fine” was soon followed by a flood of tears when her concern cut through my collected exterior. My GP’s knowledge of me caught my postnatal depression early and allowed a quick and effective intervention that saved me and my family from what might have been a very difficult time.
Of course, we know that the go-to solution for mental ill health these days is often antidepressants. New mothers, whether it is their first child or fifth, are dealing with both physical and emotional change and some will require a pharmacological intervention, but that should not be the first step. There needs to be prioritised investment in appropriate specialist services. If perinatal mental health problems were identified and treated quickly and effectively, then the serious human and economic costs for the whole country could be avoided. Not getting that right impacts on not only maternal mental health but children’s future outcomes, pressure on our health services and mothers’ ability to return to work.
Although I welcome the fact that the Scottish Government has made commitments to improve services, there still exists an unacceptable postcode lottery for mothers across the country. Of course, the issue often underpinning all of that is funding. Why, then, is it that increased funding received through the Barnett formula has not been ring fenced in Scotland as it has been in England and Wales? Our perinatal mental health services are now failing to keep up with those south of the border, which means that mothers and their children in Scotland are being failed. Perinatal mental health straddles both adult and child mental health services. We know that poor maternal mental health can significantly impact on child development outcomes and significantly limit children’s life chances. If the Scottish Government is serious about closing the attainment gap, perinatal mental health must be addressed.
There is a real requirement for significantly more joined-up thinking when it comes to the provision of our health services. Investment in perinatal mental health is exactly that—an investment—and it is estimated that failing to make it costs public services five times more downstream. That is nothing, however, compared with the human cost and suffering. Long-term investment and planning will be vital in combating the far-reaching human and economic consequences of poor perinatal mental health. I hope that the managed clinical network will now start delivering the resources for appropriate services.
We also need champions: individuals such as Clare Haughey or Claire Grieve, a midwife at Borders general hospital, who recently received the chairman’s award at the NHS Borders celebrating excellence awards for her outstanding work in improving perinatal health services in the Borders.
The birth of a child should be the most wonderful experience, yet so many new mothers struggle. We have come a long way, but the journey is not finished. If it takes a village to raise a child, then perinatal health really is everyone’s business.
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