Too many women not getting mental health support during and after pregnancy, report finds

The needs of women who have depression or anxiety during pregnancy or in the year after giving birth are not being recognised, nor are at risk women getting the support they need, a new report has revealed.

The study, Falling through the gaps, by Lorraine Khan and published by Centre for Mental Health and the Royal College of General Practitioners (RCGP), with support from Netmums, Tommy’s and the Boots Family Trust, used survey data from women who have experienced perinatal depression or anxiety, and information gathered from GPs, to find out why so few women get timely help and what would help to ensure more get access to support when they need it.

Falling through the gaps found that women fear disclosing distress to their GPs or other professionals. Also, GPs have fewer and shorter consultations with women during and in the year after pregnancy. Many doctors do not know how to respond effectively or lack confidence in their ability to achieve timely access to local psychological therapy services, it was found.

The report concludes that GPs need more and better information about perinatal depression and anxiety and how to respond. They also need to know that support will be available locally to women who need it without delays. This requires urgent action from the next government, from NHS England and from clinical commissioning groups across England to invest in improved perinatal mental health support nationwide.

“Women and GPs paint a picture of mental health difficulties not getting picked up because of fear, lack of knowledge, lack of trust in the system and lack of confidence,” said Khan, who is associate director for children and young people at Centre for Mental Health. “Sometimes problems only come to light by chance. And many women only tell their GPs about their distress in a crisis – even at this point some remain unheard. When women do disclose, it is vital that GPs respond sensitively and work collaboratively with women to get help quickly that can make a difference to them and to their baby’s wellbeing. And where there are gaps in services these need to be filled as a matter of urgency.”

Dr Judy Shakespeare, RCGP clinical lead for perinatal mental health, added: “Mental illness during pregnancy or the first few months after giving birth can have a devastating and long lasting impact on entire families. Yet many women are reluctant to admit they need help because they are frightened of being stigmatised. Those who do seek help often find that the services provided are patchy and not tailored to their specific needs.

“The Royal College of General Practitioners… recognises the importance of addressing this issue and perinatal mental health is one of our key clinical priorities for the next three years. Our aim is to ensure that all GPs have the knowledge, skills and confidence to effectively identify and treat pregnant women and new mothers who have depression and anxiety so that more women can make the most of what should be one of the happiest experiences of their lives.”

Dr Alain Gregoire, chair of the Maternal Mental Health Alliance, said: “GPs play a crucial role in identifying, supporting and treating mums who are suffering with mental health problems. Doing so is made difficult by the patchy access to the specialist help and services these women need. The RCGP and the other 80 member organisations of the Maternal Mental Health Alliance are calling for all women in the UK to have access to the services they need at this crucial time for them and their families.”