Rebecca’s Inquest: following this Alan Blunsdon : made a Kent and Medway Coroner’s request for Regulation 28 report 7th February 2019 : Report to Prevent Further Deaths. This lead to Parliamentary Question time 1st May 2019 response from P.M. Theresa May to Dover M.P. C. Elphicke to promise to improve maternal mental health care.
6B) TOO LITTLE TOO LATE
In 2007 NICE Guidelines recommended implementations which the E.K.C.C.G. has retrospectively now gained in 2019, and has been allocated £251k yearly for their Wave 1 funding for Specialist Perinatal Services, estimated by NHSE to be 75% of what is needed to meet national standards of care. The CCG have yet to complete the long term plan for this and have said they are currently using the funds for mental health intervention staff and service
This level of staff are expensive to fund, as an approximate example a Specialist Perinatal Mental Health Midwife £35k annually and Consultant Psychiatrist £250-£300 an hour.
For example, until November 2018, 18 months after Rebecca took her life, no Mother and baby Psychiatric existed, meaning going out of the county, and risking separation from the baby. Dartford now has 8 M.B.U.beds to serve a population of 4.4million in Kent, Sussex and Surrey. E.K. alone having approx. 8,000 yearly.
From charity PANDAS : https://pandasfoundation.org.
we can see for example:
By comparison, cities like Birmingham have 9 beds for a population of 1million, Nottingham has 6 for 805,800. Rural areas like Dorset has 5 for 420,500 and Winchester has 10 for 120,600. Kent’s government -to -CCG -area -funding allocation exceeds its budget because of population underestimations.
Claims that often only 7 beds are used endorses problems for mothers of accessing MIMHS and CAMHS and the fears and reluctance of mothers to engage with the threats involved in psychiatric treatment.
6C) ONE EXAMPLE OF IMPOVERISHED LOCAL SERVICES
Despite the Trusts claims, to the best of my knowledge, there remained only 2 part time specialist mental health midwives in 2020. Self referrals are recommended to Private company THRIVE. The CQC continues to call for urgent improvements. The Bill Kirkup Investigation into East Kent Hospital Trust demonstrates the LOCAL POSTCODE LOTTERY failings.
The World Health Organisation 2015 reports the UK at the 30th rank out of 183 countries including Sierra Leone and the Congo for Maternal mortality within 42 days of birth (ratio per 100,000 live births).
The impact on the mother, her infant and family are both psychological and economical.
Everglow Campaign: By providing EARLY support and assistance the physical, mental and financial cost can be avoided.
6E) BRITISH PSYCHOLOGICAL SOCIETY FEBRUARY 2016
Perinatal Service Provision; Executive Summary: The paper details the role of clinical psychology in maternity services, neonatal units, specialist community perinatal mental health services, and mother and baby units (MBUs). The paper concludes with recommendations regarding service structure, service standards and staffing levels to enable the provision of effective and efficient psychological care. The challenge for commissioners of services lies in the patchy and fragmented delivery of current perinatal mental health care. Key points l Research evidence suggests that at a conservative estimate, the long-term costs of perinatal depression, anxiety and psychosis in the UK is £8.1 billion per year, the equivalent of £10,000 for every single birth with the majority of the cost being due to adverse impacts on the child (Bauer et al., 2014). l Women often have a clear preference for psychological support for mental health problems over more medicalised interventions such as pharmacology in the perinatal period. This need underpins the critical role of clinical psychology in the delivery of high quality therapy during the perinatal period (Buist, O’Mahen & Rooney, 2015). l Psychological interventions are effective in psychotic illnesses, severe depression and anxiety, perinatal OCD, personality disorder, post-traumatic stress disorder and bipolar disorder (BPS, 2000)