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Funding needed to make Northern Irish perinatal pledge a reality

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Nursing and midwifery leaders in Northern Ireland have called for urgent investment in perinatal mental health services to address the “gross inequality” facing mothers in the region.

The call comes as all political parties in Northern Ireland signed a ground-breaking agreement to improve specialist provision for women during pregnancy and after birth.

“We must continue to work together to ensure that the necessary funding is made available”

Lindsay Robinson

The consensus statement was drafted as part of a campaign by the UK-wide Maternal Mental Health Alliance (MMHA), which is calling for urgent action to improve access to specialist care.

While there has been investment in perinatal mental health services in other parts of the UK, including England, campaigners said Northern Ireland is lagging way behind.

According to the MMHA, women and families in 80% of the region cannot access specialist community services.

Meanwhile, there are no mother and baby inpatient units in Northern Ireland or indeed the whole island of Ireland.

The statement – which was signed by all political parties including the Democratic Unionist Party, Sinn Fein, and Ulster Unionist Party – said this must change, calling for new ring-fenced funding to develop new services.

“Northern Ireland cannot be allowed to be left behind”

Julie Anderson

It has been hailed a significant step given the political stalemate in Northern Ireland which has seen the region without a government for more than two years.

Lindsay Robinson, who co-ordinates the Everyone’s Business campaign at the MMHA, welcomed the formal commitment but said it was “just the beginning”.

“We must continue to work together to ensure that the necessary funding is made available as soon as possible,” she said.

In support of the campaign, the Royal Colleges in Northern Ireland sent an open letter to the Department of Health urging the department to identify and release the resources needed to establish specialist community perinatal mental health services in each of the region’s five health and social care trusts.

The letter, signed by bodies including the Royal College of Nursing, Royal College of Midwives and Community Practitioners and Health Visitors Association, also calls for the provision of a regional mother and baby unit “as a matter of urgency”.

Dr Julie Anderson, chair of the Royal College of Psychiatry Northern Ireland’s perinatal faculty, said ring-fenced funding in mainland UK had led to “extensive development of specialist services”.

“Northern Ireland cannot be allowed to be left behind. The college feels strongly that steps must now be taken to address this unfairness of service and significant funding should be released to address this worsening situation,” she said.

“We now have an opportunity to potentially see a service transformation”

Karen Murray

Karen Murray, RCM director for Northern Ireland, said the lack of specialist services was frustrating for midwives keen to ensure women got the best care.

“For midwives in Northern Ireland it’s incredibly difficult because they can recognise women who are struggling with aspects of their mental health and can care for and support them, but the trouble is the absence of specialist services that they can refer women into and that is incredibly frustrating for midwives,” she said.

“We now have an opportunity to potentially see a service transformation that will improve the lives of mothers in Northern Ireland ensuring that perinatal mental health services are accessible in the community to those that need them most,” she added.

A Northern Ireland Department of Health spokeswoman said: “The Regional Integrated Perinatal Mental Health Care Pathway provides guidance to all health and social care professionals who come in contact with women in the antenatal and postnatal period and reflects current NICE guidelines.

“It sets out key standards of care and service requirements across primary care, core mental health services, child and adolescent mental health services, specialist inpatient services and the role of specialist community perinatal mental health teams,” she said.

She also noted that a regional perinatal mental health group was established in October 2017 to take forward the recommendations from a review of perinatal mental health services.

“Progress is ongoing and funding has been allocated to HSC trusts to ensure that appropriate equipment and facilities are available within all relevant general adult psychiatric inpatient units to meet the needs of a mother and her baby and older children during visits,” she said.

“Members of the regional group have also visited a number of mother and baby units in the United Kingdom and Ireland and, using a review of evidence-based best practice and the learning from the visits, the regional group will work to co-produce a service model to include comprehensive community-based services for perinatal mental health for Northern Ireland,” she noted.

She added: “As part of the work a whole family approach is considered to ensure the best outcome possible.”

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