APP has contributed to a Government call for evidence to inform the first ever Women’s Health Strategy for England which was published on 20 July 2022. We asked the Government to ensure that the strategy improved the lives of women affected by postpartum psychosis through continued investment in specialist perinatal mental health services, prioritising research into PP and improving support for women with PP during the menopause. We welcome these pledges, however committed funding is needed and we will continue to campaign for the needs of women with PP to be addressed in implementing this strategy.
Perinatal mental health services
“The package includes £100 million for bespoke parent-infant relationship and perinatal mental health support. We are increasing provision of specialist community perinatal mental health services, which provide care and treatment for women with moderate to severe or complex mental health needs, and support the developing relationship between mother and baby. They also offer women with mental health needs advice for planning a pregnancy. The Long Term Plan commits to at least 66,000 women with moderate to severe or complex perinatal mental health needs having access to specialist community care”
A recent study found that although affecting 20% of women, perinatal mental health receives only 4% of all research investment in pregnancy. The Women’s Health Strategy sets a 10-year ambition that “there is more research into women’s health issues – for example, gynaecological conditions, menstrual health, fertility, pregnancy, menopause and post-reproductive health – which leads to a greater understanding of conditions that impact women and how we can meet women’s health needs”.
The Government has set a 10-year ambition that “women can access high-quality, personalised menopause care within primary care and, if needed, specialist care in a timely manner, and disparities in access to menopause treatment are reduced” and that “healthcare professionals in primary care are well informed about the menopause, and able to offer women evidence-based advice and treatment options, including HRT and alternatives”
APP welcomes The Women’s Health Strategy for England pledge to invest £100 million in community perinatal mental health services and parent-infant support. We continue to campaign for equal access to MBU beds across the UK.
Changes to the Mental Health Act - what do they mean for women with PP and their families?
APP took part in a Government consultation on changes to the Mental Health Act in January 2021. The Mental Health Act is the legal framework for detaining a person for mental health treatment (being “sectioned”). As PP can escalate quickly and women with PP may lack capacity to make decisions about their own treatment, many women are admitted to hospital under the Mental Health Act.
A draft Bill was published in July 2022 and we are pleased to see the following changes which are especially relevant to families affected by PP
- There is a greater focus on patient choice and autonomy in making decisions about what treatment they would want if they should lose capacity.
- Patients can draw up an ‘advanced decision’ which explains their treatment preferences, and appoints a ‘nominated person’ to advocate for these treatments if they are detained. This can be a partner, family member or friend. The advanced decision is valid if signed by the patient, nominated person and a health professional.
- Any admission to hospital under the Mental Health Act should have a clear therapeutic benefit.
- Patients needing to be detained can no longer be held in a police cell or prison when waiting for assessment.
APP highlighted that we believe a perinatal mental health professional should be consulted in decisions to detain a woman with PP. In our experience, other mental health professionals may not be aware of the level of risk in PP, and the way that symptoms can ‘come and go’ in the early stages of the illness. This means that a woman may be assessed as having capacity or low risk when this can quickly change - causing delays to the urgent admission she needs.
APP also stressed that women with PP should always be admitted to a specialist Mother and Baby Unit as these provide specialist skills and a clear therapeutic benefit for the whole family unit. We believe that the separation of mothers and babies in general psychiatric wards goes against the principles of the new Mental Health Act.
We are very grateful to families with personal experience of bereavement due to PP who courageously shared their experience with us to include in our submission to the Government.
APP welcomes the new draft Mental Health Bill which protects the rights of women with PP who are sectioned to treatment with ‘clear therapeutic benefit’. APP has advised that all admissions under Mental Health Act for women with PP should be to a MBU.