More health visitors needed on the ground to combat lack of specialist care for post-natal depression

More health visitors on the ground visiting houses are needed to help women suffering mental health issues during or after pregnancy according to a Glasgow health visitor.

Alice O’Toole, an NHS health visitor in the East Renfrewshire area, said improvements must be made in the amount of home contact professionals have with women in the pre-natal stages.

She said: “Cases of severe psychosis are rare, and women usually experience variations of depression from, what could be termed, ‘the baby blues’ to a deeper mental health issue which needs medication.

“That being said, we are advocating for more health visitors on the ground, more contact in that pre-birth period so that health visitors have a better opportunity to assess the personality of women throughout their pregnancy, this helps to identify if a bout of depression is to occur.”

Ms O’Toole’s comments come following a  survey published in February 2017 by the Royal College of Obstetricians and Gynaecologists (RCOG) which identifies that only 7% of women in the UK who suffer mental health issues during or after their pregnancy are referred to specialist care.

The report, entitled Maternal Mental Health – Women’s Voices surveyed over 2,300 women all of whom had given birth in the UK within the last five years.

81% of those asked said they had experienced at least one instance of mental health problem during or after their pregnancy yet, of this, only 7% received specialist care in some parts of the UK.


The report identifies a geographical disparity in the quality of care available and that many women feel embarrassed about approaching  a professional about how they are feeling.

Professor Lesley Regan, President of the RCOG, said: “These survey results reveal the true impact of the care that women with maternal mental health problems currently receive in the UK and present a stark picture of how the NHS is letting down some of the most vulnerable women in our society.

“Only by listening to these women can we learn through their experiences and take urgent action to improve our services.”

Donna Collins, managing director of the PANDAS Foundation which provides advice and support for women with post and pre-natal depression, said: “[the report] unfortunately highlights the enormous variation in availability of levels of help that can be accessed across the UK.

“Investment in perinatal mental health at the earliest opportunity, although costly initially, would essentially save the financial burden in the longer term.

“In essence, to reduce the financial implications currently borne by society as a whole, further investment is essential in the short term, to brighten the future for these women longer term.”

While this report reveals the most up-to-date analysis, the issues identified are reflective of previous findings. It is thought that on average one in every five women experiences perinatal mental health issues.

A report from 2015, entitled Saving Lives, Improving Mother’s Care, found that approximately “one-quarter of all maternal deaths between 6 weeks and 1 year after childbirth were related to mental health problems and one in seven of those women died from suicide. In approximately 40% of cases, improvements in care may have made a difference to the outcome.”


For Hannah Carroll, a 23-year old mother-to-be from Paisley, the support for mental health in the pre-natal stages is far more accessible to those with a history of mental illness.

Ms Carroll, who was admitted to hospital for hyperlukemia in 2015 and had suffered anorexia for 8 years previously, said: “I wouldn’t have gotten any help if I wasn’t already ‘on the books’… so in that sense I’ve received the support from the start.

“I was meant to get discharged from the adult eating disorder services in August but they decided to keep me on because I was pregnant so they could keep an eye on me – so that I wouldn’t relapse.

“[in some ways] I wish I had been left alone but at the same time I wouldn’t have got where I am today. I think there isn’t enough information on depression and stuff after pregnancy or during.”

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