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Call for resources to tackle perinatal mental health and child maltreatment

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Midwives and health visitors can play a pivotal role in preventing harm to young children, but lack of investment in services is standing in the way, say professional leaders.

The warning follows the publication of findings from a major inquiry into perinatal mental health and child maltreatment, which found a failure to provide early support was damaging children and families and costing an estimated £23bn per year.

The inquiry, conducted by the All Party Parliamentary Group (APPG) for Conception to Age 2, set out to examine various factors affecting the emotional and social development of young children.

Its Building Great Britons report, published today, made a series of recommendations and highlighted the need for more emphasis on prevention work.

Many of the problems and poor outcomes for children highlighted in the report were “largely avoidable”, said Tim Loughton, who co-chairs the group.

“The cost of failing to deal with perinatal mental and child maltreatment has been estimated at £23bn each year,” said the Conservative MP for Worthing East and Shoreham.

“That is the equivalent of more than two thirds of the annual defence budget going on a problem that is widespread and, when unchecked, passes from one poorly parented generation to another,” he said.

“Tackling it should be no less a priority for our politicians and health and social care professionals than the defence of the realm,” he added.

“The next step must be to increase national investment into this critical period of all our lives”

Cheryl Adams

The report said clinical commissioning groups, health and wellbeing boards and local councils should draw up “1,001 days strategies” to show how they will work together to promote mental and emotional wellbeing, ensure secure bonds between children and parents, and prevent abuse and neglect.

It said the effectiveness of councils and CCGs in this area should be measured via “scorecards” and a new joint inspection regime that would bring together the Care Quality Commission and Ofsted.

Other recommendations include joint training on children’s early social and emotional development for all professionals working with young children and their families.

Meanwhile, children’s centres should become a central source of support providing access to a range of professionals, including GPs and health visitors

Professional bodies, including the Royal College of Midwives and the Institute of Health Visitors, welcomed the report, saying their members were already involved in supporting mothers and babies before, during and after birth.

Cheryll Adams, director of the Institute of Health Visitors, described the document as a “seminal piece of work”, which backed valuable work already being done by many health visiting services.

The institute has been training health visitors in perinatal mental health since 2013, as part of a Department of Health-funded scheme. It is also rolling out training on attachment between parents and children.

“The next step must be to increase national investment into this critical period of all our lives,” said Ms Adams. “Health visitors will welcome the report as it endorses many of their existing primary preventative services, but recognises the need to strengthen them.

“We really hope this new report will result in a much clearer understanding of why it is so essential to invest in very early years universal and specialist services,” she added.

“We need to invest in staff now to save money in the long-term and, more importantly, prevent more ill-health occurring”

Jacque Gerrard

Jacque Gerrard, director for England at the RCM, said midwives were “ideally placed” to support women throughout and beyond pregnancy including detecting problems and linking mothers up with the right treatment and care.

“However, to ensure midwives are able to do this there have to be enough of them to spend enough time with women, to gain their confidence,” she added.

“Without the right resources, the positive impact that could me made will not happen as often as it should,” she said. “We need to invest in staff now to save money in the long-term and, more importantly, prevent more ill-health occurring.”

She applauded the report’s emphasis on education and professional development, but warned that current pressure on maternity services meant many midwives struggled to find the time.

She also expressed disappointment at the fact the report did not recommend “skin to skin” contact for mother and baby within the first hour of a child being born.

“This helps to promote and support breastfeeding, and aids emotional attachment which will significantly improve both child mental health and reduce maltreatment in the first two years of life,” she said.

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