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Time for action on perinatal mental health care in Northern Ireland

A report on the perspectives of health visitors and midwives

Authors: Caroline Cunningham and Susan Galloway with Mary Duggan and Shona Hamilton

This report sets out the findings of a study exploring health visitors’ and midwives’ roles and experiences of identifying and responding to perinatal mental illness in Northern Ireland. For the purposes of the research, the term ‘perinatal mental illness’ covers a spectrum of mental health problems, including anxiety, depression and postnatal psychotic disorders. The perinatal period includes pregnancy and up to one year after childbirth.  This report documents the findings of a survey of health visitors and midwives who provide a universal service to women during the perinatal period in Northern Ireland. It describes their perspectives about their roles in the recognition, referral and management of perinatal mental illness; training and skillsets; and opportunities and challenges for improving the early identification of perinatal mental illness, and the response provided to women and their families in Northern Ireland.

The findings affirm that health professionals in Northern Ireland experience similar challenges in identifying and responding to perinatal mental illness as their counterparts in the rest of the UK. Within both health visiting and midwifery the main challenges are regarded overwhelmingly as systemic with underfunding, overwork and growing levels and complexity of demand undermining the face to face time and continuity of care required for early recognition and response. It also highlights issues around policy and practice in the use of screening tools, and the need for closer alignment between infant mental health and perinatal mental health practice. The report concludes with a number of recommendations.

The study was jointly undertaken by NSPCC Northern Ireland, the Community Practitioners and Health Visitors Association and the Royal College of Midwives in Northern Ireland.