COMMISSIONING: A London clinical commissioning group will start to fund a specialist community perinatal mental health service after mothers described how they only received help ‘at the point of desperation’.
Bromley CCG does not currently commission specialist community perinatal mental health services as recommended in National Institute for Health and Care Excellence guidance. It was rated “red” in a survey by the Royal College of Psychiatrists’ Centre for Quality Improvement last year.
The CCG will invest £270,000 a year in the specialist service.
It will focus on prediction, detection and treatment of mental ill health in women during pregnancy and the postnatal period, and the care of women with existing mental health problems who are planning a pregnancy, the business case says.
The CCG asked for testimonials from women who had experienced mental ill health during pregnancy.
One woman described how she had suicidal thoughts after losing one of her twins in pregnancy and after giving birth to other baby, she attempted suicide.
Her testimonial said: “It really feels as though I had to almost lose my life before any real joined up approach was agreed.”
Another mother, who suffered postnatal depression during her first pregnancy and sought help early on in her second pregnancy, said: “Despite being proactive in asking at the earliest possible opportunity, I did not get the support that I needed.”
She added that this was not due “to people not caring”. She said: “This is just a lack of resources, lack of specialist knowledge and lack of specialist support.”
The woman said that any decision to have another child would be “certainly influenced by the impact that it might have on my mental health care and the lack of support that is out there currently”.
CCG clinical lead for maternity Sally Carson said there is currently “no tool or guidance by which GPs, women, their partners and family are able to easily access professional mental health advice with a comprehensive plan of care for the perinatal period and signposting of where, when and from whom to seek help, if needed”.
She added: “This can lead to frustrating and potentially dangerous delays in seeking and obtaining help at any stage in the pregnancy and postnatal period.”
The CCG’s business case says the current perinatal mental health support is “fragmented and extremely limited” and is “reliant on non-specialist mainstream services”.
It adds that the lack of an integrated care pathway can “lead to the need for a crisis response, rather than a timely early intervention”.
A provider has not yet been chosen. The CCG anticipates the service will start in this financial year.