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DCP Faculty of Perinatal Psychology website

Transforming lives through investment in perinatal mental health in Northern Ireland

The Northern Ireland branch of the British Psychological Society is holding an event in Stormont,Northern Ireland today to endorse national guidance, Perinatal Service Provision: The role of Perinatal Clinical Psychology. The event is being hosted by Gary Middleton, MLA.

With approximately 25,000 births in Northern Ireland each year we can estimate that up to 5,000 of these women experience a mental health difficulty in pregnancy and/or the first postnatal year. 750 of these women have severe mental illness and a further 750 have PTSD related to the birth, and in some cases also to previous events. These women require the expertise of specialist perinatal mental health services but despite theoretical implementation of NICE Guidance on Antenatal and Postnatal Mental Health (2007, 2004), 80% of areas in Northern Ireland still have no access to such services. This is double the proportion with no access in England (40%). Yet NHS England has committed an additional £290 million investment in perinatal mental health services over the next 5 years. The aim is to support 30,000 more women each year to access evidence based specialist mental health care in the perinatal period, including access to psychological therapies (The Five Year Forward View for Mental Health, 2016).

Specialist services are limited to a Perinatal Clinical Psychology Service (1.5wte) which provides for all women booked to deliver at Royal Hospitals and a poorly resourced Perinatal Mental Health Team in the BHSCT which does not meet latest Royal College of Psychiatry standards (RCP, 2016 in press). NI has no Mother and Baby beds for the most severely ill women and no Specialist Mental Health Midwives.
Perinatal mental illness across the full range of severity has implications for the emotional well-being and development of the child, for the family and for society as a whole. The total long-term cost to society is estimated at £8.1 billion for each one-year cohort of births across the UK, or £250 million in Northern Ireland alone. Nearly three quarters of this cost relates to adverse impacts on the child. The overall cost equates to just under £10,000 for every single birth in the country, far outweighing the estimated cost of extra service provision, about £400 per average birth (The Costs of Perinatal Mental Health Problems Report, 2014). The considerable cost in emotional distress is less easily quantified.

The necessary Government response is wholly in keeping with identified indicators for at least three of the strategic outcomes (4, 8,14) in the Draft Programme for Government (2016-2021): i.e. improving the quality of healthcare experience, improving mental health and improving health in pregnancy.  The aim to have high quality public services by using preventative approaches to reduce future demand (Outcome 11) is also relevant. We call on our Government to prioritise the development of perinatal mental health services in Northern Ireland to reduce the stark inequity both within the Province and between the Province and England.