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Call for specialist mental health midwives in every Scottish board

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Specialist perinatal mental health midwives should be appointed across all health boards in Scotland to help “improve the situation” for other maternity staff who are forced to provide mental health support without the right education, according to a union chief. 

Her call comes as Scotland’s first minster, Nicola Sturgeon, announced a £50m cash boost to improve access to mental health services for mothers during pregnancy and shortly after birth.

“Midwives have a really crucial role in this area”

Mary Ross-Davie

Alongside this, a new report was published outlining recommendations to improve the provision of perinatal mental health care.

Recommendations included for every board to have specialist mental health provision in the community, for mother and baby units to be staffed at the recommended level, and for relevant boards to ensure a clear job description is given for specialist perinatal mental health midwives.

However, RCM director for Scotland, Mary Ross-Davie, said she also would have liked to have seen the report go further and recommend that a specialist perinatal mental health midwife be provided in every health board.

She told Nursing Times: “We at the RCM would recommend that every board looks at having a specialist perinatal mental health midwife or at least on a regional basis for health boards.

“There are examples in Scotland, but also elsewhere in the UK, where specialist perinatal mental health midwife roles make a really crucial difference to improving care,” she added.

Dr Ross-Davie explained that having the specialist midwifery role would help “improve the situation” for other midwives who were not trained in mental health. 

She said: “Often what midwives tell us is that when they are identifying someone who has mental health problems during pregnancy or after the birth of the baby, they really struggle to find someone that they can refer her to and that she can get timely cared for.

“So, it can then feel for midwives that they are then needing to provide women care in that situation, where really they should be seeing a mental health specialist,” she added.

However, Dr Ross-Davie said all midwives should be provided with some education in this area and have the ability to gain support and supervision from specialists for circumstances where a mother disclosed a mental health problem to them or if she did not meet the criteria for specialist therapy.

“Midwives have a really crucial role in this area because we’re the first point of contact for women in pregnancy,” she said. “We see women all the way through pregnancy, and so, often women trust us to tell us things that they might not feel able to tell other people.”

She explained how it was therefore “really important that midwives are well prepared and well-resourced to feel able to respond adequately”.

The report, which was funded by the Scottish Government and published by the national Managed Clinical Network for perinatal mental health, did note that a number of boards had developed a role for midwives in perinatal mental health.

It highlighted that where these roles existed there was “a real opportunity to enhance the contribution that midwives make to positive mental health promotion, and to the prevention, detection and management of mental illness”.

The network behind the report would work with multidisciplinary colleagues to provide a template job description for perinatal mental health specialist midwives to help assist boards who wished to appoint this role, the document said.

“Mental illness during pregnancy and during the first year after birth is really common”

Nicola Sturgeon

Dr Ross-Davie told Nursing Times: “It’s an evolving role and the review does recognise the positive impact those roles can have. It’s just about making sure that they’re consistent and supported.”

In terms of the cash injection promised by the Scottish government, Dr Ross-Davie said the RCM “welcomed the additional investment”.

“It’s a really significant investment in a service that is very important and very badly needed,” she added.

“We know from surveys and reviews undertaken over the last few years, that there have been real gaps in services across Scotland in terms of perinatal health provision for women, so this investment will really help to address those gaps,” she said.

According to the government, the new money will provide access to treatment for an additional 11,000 women who experience mental health problems during and after their pregnancy.

New models of service delivery under the new investment will be introduced and will include specialist care for acute perinatal mental health problems and improved infant mental health services.

Speaking on a visit to the mother and baby unit at St John’s Hospital in Livingston, the Ms Sturgeon said: “Our priority is to drive up standards of perinatal mental health care for new mothers and their children right across Scotland.

Royal College of Nursing

RCN Congress 2016

Nicola Sturgeon

“Mental illness during pregnancy and during the first year after birth is really common, affecting up to one in five women, which is 11,000 a year,” she added.

“This new funding will identify mental health problems quickly, so they can be treated promptly,” said Ms Sturgeon. “Women and their families should also expect services to treat them with dignity and respect.”

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