Increasing access to treatment for common maternal mental health problems could have a net benefit of half a billion pounds

• Independent research commissioned by the Maternal Mental Health Alliance (MMHA), conducted by the London School of Economics and Political Science (LSE), estimates the costs and benefits of addressing unmet maternal mental health needs.

• Changes to standard practice could have a net economic benefit of £490 million over ten years; £52 million in NHS savings and quality of life improvements worth £437 million.
• 1 in 5 women are affected by maternal mental health problems, which are the leading cause of maternal death in the first postnatal year.

In a new study commissioned by the MMHA, researchers from LSE evaluated the economic viability of reforming current treatment for pregnant and postnatal women experiencing common maternal mental health problems such as depression and anxiety.

The report, ‘The economic case for increasing access to treatment for women with common mental health problems during the perinatal period’, estimates the costs and benefits of a model of care which could give women’s mental health the same priority as their physical health. The model, which focuses on the essential role of midwives and health visitors, would allow for women’s mental wellbeing to be accurately assessed at every routine contact and suitable treatments to be offered – in a similar way to physical conditions such as diabetes or high blood pressure.

The proposed ‘integrated model of care’ would include dedicated maternal mental health training for health visitors and midwives as well as greater collaboration with other health care services.

In the report, resources needed to set up and provide this model of care – namely employment and training costs – are measured against their economic return. Researchers conclude that it could lead to cost savings for the NHS over 10 years of £52 million and improvements in women’s quality of life estimated at £437 million. In total, this is a net benefit of £490 million over 10 years.

In contrast, the report finds that current practice leaves many women without access to evidence-based treatment when and where they need it.

Policy analysis by MMHA member, Centre for Mental Health, determines that integrated service provision is the logical and economical next step in the evolution of perinatal mental health care in the UK. It would close a major gap and ensure women get timely access to help for their mental health needs.

For the suggested model to be effective, it must address existing inequalities in women’s experiences of maternity and mental health care. Women of colour, for example, have poorer outcomes from maternity services, including higher mortality rates. It will therefore be vital that integrated service provision is developed in an equitable way, actively seeking to meet the needs of all women, including those who are currently less well-served.

Luciana Berger, Chair of the MMHA, says:

“This report shines a very welcome light on the vital role of midwives and health visitors in identifying women with mental health problems during and after pregnancy and facilitating women’s access to treatment. It is fantastic to see a fully researched, costed model of care that would improve the lives of these women and their loved ones and also carry significant savings. With such clear evidence of human benefit and a sound investment, it is vital that we make it easier for pregnant women and new mums to access mental health support during routine contacts with their midwives and health visitors.”

Dr Alain Gregoire, Consultant Perinatal Psychiatrist and MMHA’s Honorary President, says:

“There has been fantastic investment into specialist perinatal mental health services across the UK in recent years. This has been transformative for women, babies and families affected by the most severe and complex mental health problems, but there are still major gaps for those who don’t need such highly specialised care. This research provides important evidence of a practical, cost-effective solution for addressing one of those gaps in maternal mental health services and improving the lives of so many in this generation and the next.”

Annette Bauer, lead researcher and Assistant Professorial Research Fellow at LSE, says:

“Building on our 2014 study, which highlighted the human suffering and costs linked to perinatal mental health problems, our new study shows that there are affordable ways for increasing access to treatment for women with common mental health problems that are leading to substantial quality of life improvements.”

Sarah Hughes, Chief Executive of Centre for Mental Health, says:

“Maternal mental health difficulties are common and can be serious. Every contact with a midwife or health visitor is an opportunity to offer support quickly when it’s needed. But shortages of both have made that difficult, and too many women miss out on effective early help for common mental health problems. Supporting midwives and health visitors with the training and time to meet women’s mental health needs is a sound investment that could make a difference to many thousands of women and their families.”

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Notes for editors

Contact
media@maternalmentalhealthalliance.org

• Report available here
• This independent research was commissioned by the MMHA and conducted by the Care Policy and Evaluation Centre at LSE
• Policy analysis by MMHA member, Centre for Mental Health, available here
• Available for interview: Dr Alain Gregoire, Luciana Berger, Sarah Hughes, lead researcher Annette Bauer, midwifery and health visiting representatives
• Examples of common maternal mental health problems include depression in pregnancy and postnatally and anxiety disorders like phobias and OCD
• 'Quality of life measures' is a standard research tool which looks at the cost of each additional month/year of life gained by a treatment and the quality of that life, including physical/mental ability to do basic daily activities.
• Workforce shortfall: The Royal College of Midwives (2021) warn that the NHS in England face a shortage of 2,000 midwives and rising. The Institute of Health Visiting (2021), estimate a national shortage of 5,000 health visitors. In addition, this research finds that a further 347 midwives, 891 health visitors and 302 mental health workers are required to change current practice and help achieve parity between physical and mental health care.
• A previous report (LSE & Centre for Mental Health, 2014) showed that the costs of untreated perinatal mental health problems amounted to £8.1bn for every year of women giving birth.
• Information and support is available for anyone affected by the issues raised
• The MMHA is a UK-wide charity and network of over 100 organisations dedicated to ensuring women and families affected by perinatal mental health problems have equal access to high quality, comprehensive care.
• LSE‘s Care Policy and Evaluation Centre is an international research centre working mainly in the areas of long-term care (social care), mental health, developmental disabilities and other health issues.
• Centre for Mental health is an independent, not for profit think tank dedicated to eradicating mental health inequalities and fighting injustice by changing policy and practice.