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London School of Business Economic Costs of Perinatal Mental Illness in UK

Commissioned by the Maternal Mental Health Alliance, the London School of Economics have  produced a report detailing the £8bn per annum economic cost of perinatal mental illness in the UK.

Perinatal mental health problems carry a total economic and social long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK, according to a new report ‘The costs of perinatal mental health problems’ released today by the London School of Economics and Centre for Mental Health.[i]

However the report also finds that the NHS would need to spend just £337 million a year [ii] to bring perinatal mental health care up to the level recommended in national guidance. [iii]

Launching officially in Parliament on Tuesday 21st October, the report finds that the costs of mental health problems among women in pregnancy are far greater than previously thought; the cost to the public sector of perinatal mental health problems is five times greater than the cost of providing the services that are needed throughout the United Kingdom.

‘The costs of perinatal mental health problems’ finds that:

  • Perinatal depression, anxiety and psychosis together carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK.
  • Nearly three-quarters (72%) of this cost relates to adverse impacts on the child rather than the mother.
  • Over a fifth of total costs (£1.7 billion) are borne by the public sector, with the bulk of these falling on the NHS and social services (£1.2 billion).
  • Other costs include loss of earnings/impact on someone’s ability to work and quality of life affects.

There is clear guidance from the National Institute for Health and Care Excellence (NICE) and other national bodies on the treatment of mental illness during and after pregnancy. Yet the current provision is best described as patchy, with significant variations in coverage around the country:

  • About half of all cases of perinatal depression and anxiety go undetected and many of those which are detected fail to receive evidence-based forms of treatment.
  • Specialist perinatal mental health services are needed for women with complex or severe conditions, but less than 15% of localities provide these at the full level recommended in national guidance and more than 40% provide no service at all.[iv]

“Perinatal mental health problems are common and costly. They affect up to 20% of women at some point during pregnancy or in the year after childbirth and are a major public health issue impacting on both women and baby.

The good news is that women recover when they get the right treatment. It is vital that all women, wherever they live get the specialist help they need.”

Dr Alain Gregoire, Maternal Mental Health Alliance Chair

Summary of Economic Report – costs of Perinatal Mental Health problems

Final Economic Report – costs of perinatal mental health problems

JBMF Response to LSE Report on Economic Costs of Perinatal Mental Illness

This report highlights and confirms what many have experienced, that despite promises by the government and the NHS over a decade ago to implement specialist perinatal mental health services across the UK, the failure to do so results in the “unnecessary suffering” and “avoidable deaths” that costs the UK economy more than £8bn per year.

Many people do not realise that the suffering of these mums has an adverse impact on the development of their children during the “first 1001 critical days. Behavioural problems, reduced learning ability, increased likelihood of depression prior to age 16 and a life-time exposure of increased risks to mental illness are all a result of the exposure of the developing child to toxic stress.

In my own case:

  • Joe and I never had the chance to access the specialist perinatal mental health services that should have been treating her when she died and who could have prevented her “avoidable death”.
  • It took nearly 4 years of fighting for the truth before the NHS finally accepted in December 2013 what the Coroner reported in his Statement of facts. The NHS admitting that their “breach in duty of care” was the probable cause of my wife’s death and that if in accordance with care standards she had been admitted to the Mother and Baby Unit in Leeds where specialist services were available she would still be alive today.
  • Whilst coming to terms with the avoidable loss of my wife and its impact, I also learnt about the increased risks and adverse consequences on the future health and well-being of my daughter.
  • But we must consider all those affected on the day that my wife died. The 2 train drivers and the conductors who needed psychiatric treatment for shock along with the members of public and the young child who witnessed my wife Joes’ body being torn apart as she lay down on the train tracks.

86% of Maternal Deaths by Suicide are identifiable, treatable and recoverableiv. Of the average 50 deaths every year approx. 43 are “avoidable deaths” iv. That is why I established Joe’s charity to raise awareness and fight for improvements so others don’t suffer unnecessarily like Joe and I did.

The charity provides the information that the NHS never provided to Joe and myself so that people know what support they should be asking for and what options should be available to them:

Whilst this economic cost report goes someway to providing the necessary evidence that specialist perinatal mental health services are a necessity and not a luxury, action is required not words. MP’s must take responsibility for delivering on their forgotten promises. Following the death of Daksha Emson the government at the time and the NHS promised to implement services…. Yet they did not why?

The complete and utter failure to implement the specialist perinatal mental health services leaves mums, dads and their families picking up the pieces and the costs.

Perinatal Mental Health Care – The key to unlocking Mental Health

MPs and Parliament need to hold to account those responsible for delivering the necessary changes and improvements to bring services across the UK up to care standards. This is why we are campaigning for a “Parliamentary Commission” to investigate why mums, dads and families are not receiving the correct information, support, care and treatment and have parliament ensure that changes are implemented.

Chris Bingley, Joanne Bingley Memorial Foundation, Founder

[i]The costs of perinatal mental health problems report is available online Monday 20th October 2014

The report was produced by the London School of Economics and Centre for Mental Health for the Everyone’s Business campaign led by the Maternal Mental Health Alliance and funded by Comic Relief.

[ii]This figure is based on a calculation for England (£280million) which translates into an estimate for the whole of the UK and is equivalent to spending an extra £407 per child born each year across the UK

[iii] National Guidelines: The Royal College of Psychiatrists CR88 2000; The Women’s Mental Health Strategy 2002; The Scottish Maternity Framework 2002; The Children and Young People’s NSF Maternity Standard 11 2004; NICE Guidelines on Antenatal and Postnatal Mental Health Care 2007; The Confidential Enquiries into Maternal Deaths 2011; NICE Guidelines Caesarean Section 2011; The Royal College of Obstetricians and Gynaecologists’ Guidelines on Management of Women with Mental Health Issues during Pregnancy and the Postnatal Period (Good Practice No 14) 2011; The SIGN Guidelines 2012; Joint Commissioning Panel for Mental Health, Guidance for Commissioners of Perinatal Mental Health Services 2012.

iv The Confidential Enquiries into Maternal Death, produced every 3 years and review of the causes of maternal death and how to prevent them.

In line with national guidelines, a specialist community perinatal mental health service should be multi-disciplinary and feature a consultant perinatal psychiatrist, specialist psychological treatment for the mother and for her relationship with her baby, as well as formal links with local GP, health visitor, midwife and IAPT or equivalent leads and relevant services in the community and voluntary sectors.

[iv] Please click here to view the outcome of a recent mapping exercise to assess the levels of specialist community and inpatient perinatal mental health services across the UK from the #everyonesbusiness campaign