Mothers missing out on specialist mental health support due to insecure funding

Access to specialist maternal mental health services remains uneven in the UK despite significant progress made since 2013, a new report says.

The report from the Maternal Mental Health Alliance also finds that mental health-related deaths during pregnancy or up to six weeks after birth are increasing, emphasising the urgency of addressing the issue. Around 1 in 5 women experience mental health problems during or after pregnancy and suicide remains the leading cause of direct maternal death in the first postnatal year. The alliance says that it is ‘critical’ that those with the most severe and complex illnesses can access specialist care close to home.

Using Freedom of Information (FOI) requests to look at budget allocation and spending on services, the report found that although the vast majority (89%) of those responding had seen their budget increase from 2020/1 to 2022/3, two-thirds (66%) indicated there would be an underspend for 2022/3.

Workforce-related issues were the most frequently cited reason for underspending (58% of respondents), but many teams provided evidence indicating this was due to unclear or late budget allocation, with no guarantee of continuation. The report said this is inevitably resulting in women, babies, and families not receiving the care they need.

“We have had no increase in funding since inception of service,” one healthcare professional said. “Despite our understanding that this should be ringfenced commissioners and managers have spent this money elsewhere. We have protested but with no effect. Nonetheless, the expectation that we see more women each year (in line with trajectories as if funding had filtered down) continues. We are working far beyond funded capacity which – as predicted and highlighted repeatedly – is now manifesting as increased sickness, stress, burnout and increased staff turnover.”

Authors of the report say that secure funding is vital for maintaining and building upon the progress made with the expansion of specialist Perinatal Mental Health (PMH) services. Without it, they say recruitment will be impacted, exacerbating existing problems of understaffing and low morale, and ultimately specialist services may struggle to deliver urgent and necessary care to women who desperately need it. To break this cycle, teams must be shown that there is secure funding available.

Consultant Perinatal Psychiatrist Dr Alain Gregoire, Maternal Mental Health Alliance President, said that the although the last ten years had seen a growing understanding of the importance of specialist care for maternal mental health, it was crucial that this momentum and commitment is maintained.

“National and local decision-makers must ensure that allocated resources reach clinical services to ensure that mothers, babies, and families can access the care they need. We must grasp this exceptional opportunity to make a real and lasting impact on the lives of women, babies, and future generations.”

As a result of the findings, the report recommends addressing short- and long-term workforce issues, and making it easier to understand how much money is being spent on PMH services in each local area with more accessible data and transparent mechanisms.
“It is crucial that momentum is maintained and Government commitments to improving specialist PMH services are fulfilled. The MMHA remains dedicated to working closely with members, Lived Experience Champions, and national and local partners to promote continued progress,” Dr Gregoire continued.