A growing number of women with maternal mental health problems such as postnatal depression are not receiving life-saving treatment designed to keep families together, protect babies and reduce the risk of maternal suicide.
An inventory of maternal health services from the Ministry of Health revealed an increasing complexity of mental health needs in hospitals across the country, with officials warning of a huge amount of unmet need in the community, a shortage of staff, gaps in services, systemic inequalities and models of caring.
Hospital staff often had ideas for improving service, according to the report, but were “unable to implement them within existing arrangements.”
Very few district health boards nationwide focus on women from the Pacific or Asia, although the Growing Up New Zealand longitudinal study found that they are twice as likely to experience prenatal depression as women. European women from New Zealand, and few have a Maori Kaupapa Maternal Mental Health Service.
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Hospital specialists see people with increasingly complex maternal mental health needs. (File photo)
“DHB are not seeing as many women who may have higher needs than expected, especially Maori Wāhine women and women from the Pacific and Asia,” said the report, which was released recently.
“These findings reflect systemic inequities, including concerns that wāhine Māori, pēpi and whānau are not receiving the care to which they are entitled under te Tiriti o Waitangi.”
Complex mental health needs were often the result of birth trauma, including the loss of a baby and other issues such as family violence, housing difficulties, and substance abuse. But the eligibility criteria for accessing maternal mental health hospital services require a living child, excluding women whose babies have died if they have no other dependent children.
All but one of the boards raised manpower issues, including the need for more staff, especially psychiatrists and psychologists.
It was difficult to prove that maternal mental health issues were on the rise, but ministry data shows that calls to PlunketLine regarding maternal mental health in the first four months of 2021 have already exceeded the total number of calls on the same. subject in 2020.
More training in maternal mental health was needed for midwives, general practitioners and staff at Well Child Tamariki Ora. A shortage of community care meant that a higher proportion of women ended up needing specialist hospital support.
“They think this is probably due at least in part to a lack of support in the community and primary health care sector, for example, in the areas of psychological therapy, systematic and effective screening and early intervention. in primary health care, ”the report says. noted.
The Perinatal and Maternal Mortality Review Committee of the Health and Safety Quality Commission has repeatedly requested the Ministry of Health to undertake the inventory. It will be used in response to a recommendation from the ministry’s National Maternity Monitoring Group that improves access to primary mental health services for pregnant and postpartum women.
Associate Health Minister Dr Ayesha Verrall, who said she had also requested the inventory, said the government would invest $ 500,000 in the District Health Boards of Lakes, Northland, Waitematā, counties of Manukau and Hawke’s Bay to strengthen support for early intervention initiatives for women with mild to moderate maternal mental health conditions.
Work is already underway on bereavement support for those experiencing the loss of a child.
Further changes would come in health reforms to abolish district health boards, she added.
“The Ministry of Health is also working with the Health Reform Transition Unit to develop a national pathway to access maternal mental health services. “
Suicide is the biggest killer of pregnant women and new mothers in New Zealand, while Aotearoa has significantly worse mental health outcomes for new mothers than in the UK and Australia. One in five people will develop some form of mental distress during their pregnancy or in the first year after giving birth.
The situation is even more dire for the Maori. Fifty-seven percent of those who died by suicide during pregnancy or within six weeks of birth were Maori wāhine, while New Zealand’s maternity suicide rate is seven times higher than in the UK .
Where to get help
- 1737, Need to talk? Call or text free to 1737 to speak to a qualified advisor.
- Anxiety New Zealand 0800 ANXIETY (0800 269 4389)
- Depression.org.nz 0800 111 757 or SMS 4202
- Children line 0800 54 37 54 for people up to 18 years old. Open 24/7.
- Safety rope 0800 543 354
- Mental Health Foundation 09 623 4812, click here to access its free resource and information service.
- Rural support trust 0800 787 254
- Samaritans 0800 726 666
- Suicidal crisis helpline 0508 828 865 (0508 TAUTOKO)
- Yellow brick road 0800 732 825
- thelowdown.co.nz Web chat, email chat or free text 5626
- What’s new 0800 942 8787 (for 5 to 18 years old). Telephone consultation available Monday to Friday from noon to 11 p.m. and on weekends from 3 p.m. to 11 p.m. The online chat is available every day from 3 p.m. to 10 p.m.
- Youth line 0800 376 633, free text 234, email [email protected], or find live chat and other support options here.
- If it is an emergency, Click here to find the number of your local crisis assessment team.
- In a life-threatening situation, call 111.
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