Our guest blogger is Dr Alain Gregoire, a Consultant Perinatal Psychiatrist and Honorary Senior Lecturer. Alain is also founder and Chair of the Maternal Mental Health Alliance, a coalition of over 70 national organisations committed to improving maternal mental health, of which NCT is an active member.
Perinatal mental health problems are some of the most treatable conditions we know of and many are even preventable. Unlike NHS care for similarly serious and life threatening physical conditions, the NHS has been getting away for years with ignoring evidence based guidelines on effective treatment and services. The UK has developed some of the most advanced models of care in the world, but as a result of one of the worst postcode lotteries in the NHS, women in most parts of the country do not have access to such services and have been suffering and dying unnecessarily.
The Maternal Mental Health Alliance (MMHA) wants all women across the UK to have access to the consistent, high quality care and support for their mental health during pregnancy and in the year after birth that NICE guidelines recommend. We are excited that NCT is so energetically joining forces with us in this endeavour – through campaigning, developing peer support programmes and raising awareness to bring perinatal mental illness “out of hiding”.
It’s a little known fact that depressive illness is the most common major health complication of maternity and that suicide is a leading cause of maternal death.
Even more surprising to many is that 1 in 2 parents have had fears of deliberately harming their baby. So this is a problem that is likely to affect many of us in some way, directly or indirectly.
Anyone who cares about the wellbeing of this generation or the next, or our collective futures must seek change, both in terms of clinical services and public awareness. So much needs to be done to make sure that healthcare professionals understand how to support women and prevent, identify and treat mental health problems at this critical time. For example, women with existing mental health conditions, such as bipolar disorder, have an especially high risk of experiencing severe mental health problems postnatally. How many are even told this, let alone given the necessary advice and care to prevent this mental health emergency?
And then there is the tricky issue of taking medication during pregnancy and breastfeeding, which can be a worry for so many women. Far too few get good advice on this, and as a result few realise that It is often more of a risk to come off medication, as this can result in an episode of illness, which may be harmful to mother and baby.
The current neglect by the NHS is particularly scandalous when we consider the impact maternal mental health can have on the wellbeing of babies and children. What we experience in our first 1,000 days has a profound impact both our physical and mental health well into adulthood.
I’m sure I am preaching to the converted on that front but it is worth highlighting the importance of maternal mental health on attachment in this key developmental period and the importance of this to the child’s ongoing mental health. We are now also uncovering the epigenetic effects on the unborn child that can result from untreated mental illness during pregnancy, and the potential for transgenerational effects.
However, increased risks certainly do not equate to inevitability and these effects are potentially reversible when parents have access to the right care and support.
We have a fantastic opportunity to positively influence the lives of so many – not only of this generation but also many generations to come –by improving the care and support of parents suffering from mental health problems now.
It is vital that society as a whole takes its role seriously. This can’t be just a medical solution – we all need to value and nurture parents and children much more and understand the critical importance of attachment and the first 1,000 days.
So no-one should underestimate the immensely powerful role that NCT’s army of teachers, volunteers and peer supporters play in supporting parents, as well as campaigning to make sure that maternal mental health gets the emphasis and resources it deserves. You are making an enormous difference to parents and children across the UK, both now and for generations to come.
Alain Gregoire gave the keynote speech at NCT’s National Celebration Day on 4 November and the slides from the talk are available here. You can help to build pressure for change by emailing your MP about the #HiddenHalf campaign here.