As Mental Health Awareness Week draws to a close, Willie Rennie again used his questions to the First Minister to highlight the crisis in Scotland’s mental health provision:
Post-natal depression and depression during pregnancy affect up to one in five women. Half the women who experience it will go undetected and untreated.
During an FMQs session in April, Willie Rennie highlighted the lack of perinatal mental health services and drew attention to the fact that new mothers in half of Scotland cannot access specialist services. Only Glasgow meets the required standard in the whole of Scotland.
Scottish Liberal Democrats have a number of ideas to provide better perinatal services. They include:
- The six week post-natal check to include support from a GP and Health Visitor with specific training on maternal mental health;
- Referrals to suitable community support networks, supported by a health visitor;
- Inpatient care to allow mothers to continue caring for their babies and be close to home;
- A new campaign to remove the stigma of mental ill health for new mothers;
- A new plan to increase core training for GPs and health visitors in identifying and treating maternal mental health.
Yesterday there was a debate on perinatal mental health at Holyrood:
Our health spokesperson Alex Cole-Hamilton MSP said:
Welcome to the best club in the world. Your life is going to change, but only in good ways.” Those are some of the words that society utters whenever someone is expecting a child. With such a weight of societal expectation around pregnancy and parenthood, it is not surprising that it is difficult for mothers to come forward and admit that they are not necessarily coping or enjoying the experience in the way that they thought that they might. However, for all too many mothers, that is the reality. It is a hidden issue in our mental health landscape and I am glad that we are airing it today.
As with many other mental health issues, perinatal mental ill health is a spectrum. It can be severe or mild; it can involve anxiety or depression; it can involve obsessive-compulsive disorder; and it can lead to post-traumatic stress disorder and real psychosis in some extreme cases.
Perinatal mental ill health happens during or after pregnancy. I will take a moment to recognise a group that is not often a mentioned in such debates: those who miscarry. My sister, Rosie, who is in the gallery this afternoon, is one such person. She miscarried in 2016 and then suffered mental health issues directly afterwards. She has allowed me to share her words with the chamber this afternoon. She said:
“It hurts so much. Along with the feelings of guilt and failure at not successfully bringing my baby into the world, there was a chemical change that I didn’t understand or expect.”
Rosie is among many mothers or would-be mothers who suffer in that way, and we need to do far, far more for them.
There is a tension, because the stigma of not wanting to put up their hand and say that they are not coping gets in the way of identification. That is why the six-week check, which every new mother undergoes, is all important. However, it means nothing if our doctors, midwives and health visitors are not adequately trained to understand the early-warning signs that show that someone is just not coping or might need a little bit of extra support. We urgently need to rectify that and make sure that, as a matter of course, people are adequately trained in perinatal mental health issues.
Once we identify those women, we do them a profound disservice if we cannot back that up with adequate service provision in the communities and hospitals in their locale. We know that less than half of mothers are served by adequate perinatal mental health facilities or services either in their communities or in their local hospitals.
I am intensely proud to have been involved with Aberlour when it started its perinatal befriending service in Forth Valley. All told, it has helped 160 mothers in that area since it started three years ago, but there is no guarantee that the service will be able to be sustained when the funding goes. We need to mainstream such services right across the country so that there is no postcode lottery.
The worst comes when we talk about in-patient provision. In this country, on any given day we have only 12 beds available to mothers and their babies to come in for perinatal mental health support. If those beds are full, mothers are directed to adult services and cannot take their babies with them. We are compounding the mental turmoil of the chemical changes that are going on in their brains with the separation anxiety created by having to remove their child from the situation. That has to be the nexus of where we take the agenda, because it is an absolutely critical point.
I thank Clare Haughey once again for the opportunity to have this debate, and I thank the campaign. It is very easy for us to let these women drift back into the shadows and try to muddle through and carry on regardless, but they are looking to the chamber for answers. It is time that we woke up to that.
* Caron Lindsay is Editor of Liberal Democrat Voice and blogs at Caron's Musings