Almost 15,000 women affected by perinatal mental illness per year, HSE says

An estimated almost 15,000 women are affected by perinatal mental illnesses in Ireland each year, the Health Service Executive’s national clinical lead for the service has said.

As a result, perinatal mental health is “a vitally important component of mental health services in lreland”, as those involved in the sector say a mother and baby mental health unit is “key” to improving outcomes for mothers and children.

Perinatal refers to the period from when a woman becomes pregnant until up to a year after giving birth.

Speaking at a meeting of the Oireachtas subcommittee on mental health on Tuesday morning, Dr Margo Wrigley said the most common type of mental illness among mothers is mild to moderate depressive illness and anxiety states.

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Just over 2,000 women are diagnosed with post-traumatic stress disorder (PTSD) each year after giving birth, with a further 2013 being diagnosed with severe depressive illness.

Some 134 mothers are diagnosed with chronic serious mental illness, while a further 134 are diagnosed with post-partum psychosis.

Dr Wrigley said a national mother and baby unit is “absolutely key” to improving mental health among mothers. Currently, if a mother develops a severe perinatal mental illness, she is generally separated from her baby.

“The effects are not just the immediate; for the infant it is lifelong in terms of having an impact into adulthood,” she said.

“If it was prioritised at Governmental level, it would make a huge difference to our progress. From our point of view, from the mother and baby unit, it needs to be a part of but distinct from an acute mental health service.”

Dr Amir Niazi, national clinical adviser and group lead for mental health, said all options are being looked at in terms of choosing a location for the mother and baby unit.

“We are engaging with the department and the HSE to see what will fulfil our needs. Want to make sure what we develop is something we can stand over,” he added.

Prof Anthony McCarthy, a consultant perinatal psychiatrist at the National Maternity Hospital, said a mother is 19 times more likely to be admitted as a psychiatric inpatient in the first six weeks after the birth of a baby than in any other six-week period in her life.

The psychologocial and social challenges of pregnancy are “considerable for many”, he said.

“Previous psychological or psychiatric issues are frequently exacerbated by pregnancy, and very often new and seriously challenging issues ... present for the first time,” he said.

“Previous mental health difficulties, such as anxiety, depression, bipolar illness, post-traumatic stress disorder, do not disappear in pregnancy and are often complicated by it and frequently worsen after it unless addressed and appropriately treated. And all of these pose considerable risks to the wellbeing and sometimes safety of the mother, her baby, and her family.”

Suicide is the second most common cause of maternal death in this country, he added, and infanticide, while rare, “is frequently preventable and rates are probably underestimated”.