How a counselling service supports mums with postnatal issues

Project
MumsAid Postnatal Counselling Service

Purpose
To support mums struggling with various issues including postnatal depression

Funding
Included a £3,500 grant from UnLtd to set up a social enterprise, plus funding from Greenwich Council. The scheme receives about £20,000 a year

Background
There are about 5,000 births each year in the London Borough of Greenwich. With postnatal depression affecting an estimated one in five new mothers, this poses a challenge to health and support services in the borough.

Miriam Donaghy, founder of MumsAid, developed a postnatal support group while working for Greenwich Mind, but soon realised many mums needed individual counselling. She went on to work with the Tavistock Centre for Couple Relationships on a parenting project, which also showed the need for support to address postnatal depression. As a result, she launched the MumsAid Community Interest Company, which offers one-to-one counselling.

Action
Donaghy runs the service alongside a team of volunteers including three qualified counsellors. Referrals come mainly from health visitors, as well as GPs and children's centre staff such as family support workers.

The service operates out of four children's centres, including two in Woolwich, and mothers get free childcare in centre crèches while they attend. "This is a very diverse area with a lot of challenges and a lot of call for the service," says Donaghy. "We keep it quite broad, so the idea is to support women if they are struggling and can't manage to do the best for their baby as a result.

"Some may have a classic postnatal depression diagnosis, but others may be struggling because their partner has left them, or because of immigration or housing issues."

Mums get one hour of counselling a week usually for 12 weeks, although the service takes a flexible approach. "Part of what we're doing is simply holding someone," says Donaghy. "So people have a sense there is someone there for them. Once they settle down, we may extend the time between sessions." This means the service may work with people across the course of a whole year. "If someone is in crisis, like they have just heard from the Home Office that they're going to be deported, then we won't just drop them. So they may get more than 12 sessions - we hang onto people." Mums also get follow-up appointments to check how they are getting on.

Basing the service in children's centres has led to mums getting more involved in other services on offer there, such as play sessions or self-development courses. "They might be someone who has never been to a children's centre before," Donaghy explains.

The service works with 40 to 50 mums a year and there will usually be 12 people at any one time using the service. Donaghy says she would like to do more and hopes to work closely with the local clinical commissioning group in the future.

While the project gets about £20,000 a year, the true cost of delivering such a scheme is more like £50,000, she says.

The service recently set up a Facebook page and is exploring other ways to use social media to support mums and help them to support each other. It plans to work with the charity HomeStart to develop a peer support scheme.

Outcome
An evaluation of the service, published in the Journal of Family Therapy, used before and after questionnaires, and measures including the Edinburgh Postnatal Depression Scale. Individual scores on this scale improved for all mothers who completed counselling.

The mean score fell from 19.2 before mums had counselling, to 10.8 afterwards. All but one of the mothers had moved to below the depression threshold of 11. Of the three mums who had said they were at risk of self-harm and suicidal thoughts, two were no longer at risk after counselling and the remaining mum saw her score drop from a high 26 to 19.

All mothers who identified confidence in their parenting as an issue beforehand showed a marked improvement after. They were also asked to rate how stressful they found the experience of parenting on a scale of one to five. Scores improved for all but one, and the overall mean score decreased from 2.7 before counselling to 1.8 after.