Overview of challenges to implementation of good practice in perinatal mental health promotion and management, in universal primary care and community services
| Date | 18 September 2017 |
| DOI | https://doi.org/10.1108/JPMH-03-2017-0009 |
| Published date | 18 September 2017 |
| Pages | 100-103 |
| Author | Lucy Marks |
| Subject Matter | Health & social care,Mental health,Public mental health |
Overview of challenges to
implementation of good practice in
perinatal mental health promotion and
management, in universal primary care
and community services
Lucy Marks
Abstract
Purpose –The purpose of this paper is to describe some of the barriers and solutions to implementing
good practice in perinatal mental health promotion in universal services, and propose some
ways forward.
Design/methodology/approach –This paper describes the rationale and evidence base for proactive
management of perinatal mental health in primary care and community services and good practice
recommendations. There is considerable evidence that these recommendations have not been implemented
nationally in the UK. A range of solutions and proposed ways forward to manage barriers to implementation
are set out.
Findings –It is proposed that a number of factors need to be in place in order to deliver best practice in
perinatal mental health.
Originality/value –The value of this paper is to set out what needs to be in place in order for services to
promote good perinatal mental health and secure attachment and change the life chances of children and
their parents, by intervening early. This will also ultimately save financial resources for public services,
because the quality of early relationships is linked to health and mental health.
Keywords Perinatal mental health, Reflective supervision, Health visitors, Maternal mental health,
Midwives, Training in perinatal mental health
Paper type Conceptual paper
Marmot (2015) provides evidence that what happens in the early years has a profound effect on
life chances and health for adults. Early childhood development is influenced by the quality of
parenting, which in turn is influenced by the circumstances in which parenting takes place.
He cites the Adverse Childhood Experiences Study (Felitti et al., 1998) showing that the higher
the number of adverse experiences as a child (including emotional, physical or sexual abuse), the
greater the risk of not only developing depression and attempting suicide, but also physical
health problems such as diabetes, stroke and heart disease.
Much has been written about the importance of the development of secure attachment and the
fact that relationships in the first two years can have a lifelong impact (see The 1,001 Critical
Days, Cross Party Manifesto, Leadsom et al., 2014). A parent’s capacity to be attuned to their
infant and recognise they have a separate mind with intentional states is the building block for
being able to process emotions and develop good mental health (Fonagy et al., 2004).
The National Institute for Health and Care Excellence (NICE) (2014) guidance on Antenatal and
postnatal mental health recommends active screening and management in primary care or at
Received 15 March 2017
Revised 17 May 2017
Accepted 30 May 2017
The author would like to thank
Azom Mortuza and Jane Gibbons
for their invaluable encouragement
and advice and on the
development of this paper.
Lucy Marks is the Chief
Executive Officer and a Clinical
Psychologist at Compass
Wellbeing CIC, London, UK.
PAGE100
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JOURNAL OF PUBLIC MENTAL HEALTH
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VOL. 16 NO. 3 2017, pp. 100-103, © Emerald Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-03-2017-0009
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