Postnatal mental health checks missed due to health visitor shortage

According to the Institute of Health Visiting (IHV)’s State of Health Visiting Survey 2015, one in four health visitors do not have enough time to provide postnatal mental health (PMH) assessment to families at six to eight weeks, as recommended by the government.

In addition, three quarters of respondents said they are unable to carry out government recommended maternal mental health checks three to four months after birth.

The PMH checks are a key part of the government's maternal mental health pathway. Previous research involving clinical trials with 4,000 mothers found that those who received health visitor support were 40 per cent less likely to develop post natal depression after six months.

The IHV says although health visiting has benefited from extra investment in the last five years these latest figures show how long-term under resourcing continues to impact on workloads.

Health visitors are also reporting a rise in mental health problems as well as stress factors in family life such as financial worries and domestic abuse.

Of the 1,413 health visitors surveyed, 68 per cent said they had seen an increase in postnatal depression over the last two years, while 81 per cent had seen a rise in domestic violence and 69 per cent an increase in poverty over the same period.

IHV director Dr Cheryll Adams called on commissioners to “make sure that health visitors have the time to provide PMH assessments at 6-8 weeks and again at 3-4 months”.

She added that over the last two years, 10,000 health visitors have undertaken IHV training around mental health problems, domestic violence and safeguarding. In addition, the IHV has trained 573 perinatal "mental health champions" to support local training.

In August, the Community Practitioners’ and Health Visitors’ Association also
revealed concerns among health visitors around heavy workloads. In its survey of 751 health visitors, 89 per cent said they were taking on more responsibility for children and families with 50 per cent fearing this was causing safeguarding concerns.

Recent investment in health visiting includes an extra £428m in government funding between October 2015 and March 2016 to help disadvantaged areas take on new public health responsibilities for families with babies and young children.

The coalition government also increased funding for health visiting to recruit an extra 4,200 health visitors by 2015, a target it narrowly missed.