HSE employs two full-time psychiatrists to treat 60,000 new mothers each year

‘Atrocious’ lack of perinatal care criticised as 12,000 women require mental healthcare

 The State’s only full-time perinatal psychiatrists are located in Dublin and Limerick. Photograph: Katie Collins/PA Wire

The State’s only full-time perinatal psychiatrists are located in Dublin and Limerick. Photograph: Katie Collins/PA Wire

 

Ireland has just two full-time specialist psychiatrists for every woman in Ireland who is either expecting a baby or who has recently given birth.

An official report last year demanded that seven be employed country-wide. The HSE’s own policy states that there should also be 10 specialist mental health nurses in maternity hospitals across the State, but it has confirmed there are only two.

More than 12,000 women require mental healthcare before or after having a baby every year, based on a typical 64,000 births a year.

James Browne, Fianna Fáil’s mental health spokesman, said the “atrocious” lack of perinatal care feeds into a narrative of revelations from the recent referendum on the Eighth Amendment to the cervical cancer scandal and the adoptions controversy.

“Only two consultants in place, only two nurses, for the entire population of women who are pregnant or who have given birth – it is an absolutely stark figure. Effectively, the service doesn’t exist outside of Dublin. Someone in Cork or Galway who needs that support, it simply is not there. In 2018 it is unacceptable.”

Mr Browne said any expecting or new mothers with mental health issues “need very particular support and care, and clearly they are not getting it. They can’t be with that number.”

Relationship

Perinatal mental health disorders, which complicate pregnancy and the first year after the birth, are regarded as unique in their potential to affect the relationship between mother, child and family, with subsequent consequences.

It is estimated between 6,400 and 9,600 women in Ireland every year are likely to suffer mild to moderate depression while pregnant or after giving birth.

Up to 2,240 may suffer more serious mental illness. Around 130 are likely to suffer from a postpartum psychosis, and the same number again are likely to suffer from other serious or complex disorders.

The risk of PTSD (post-traumatic stress disorder) after emergency Caesarean section – the prevalence of which is increasing – mean the overall figures “are likely to be an underestimate”, according to the HSE’s own report on perinatal mental health.

Launched last November, it states there should be seven full-time perinatal psychiatrists and 10 designated mental health nurses.

Prof Anthony McCarthy, one of Ireland’s two full-time consultant perinatal psychiatrists, based in the National Maternity Hospital, said the HSE was moving in the right direction.

“We are coming from a stark history, we’re coming from a stark background. But we finally have some movement. The history of how Ireland has treated women in pregnancy plus how Ireland has put such a low priority on mental health – put the two together and it is not surprising that perinatal mental health is a way behind.”

The other full-time psychiatrist is based at University Maternity Hospital Limerick.

Part-time posting

The HSE said it was currently “in process of approval” for a full-time consultant post for the Coombe, which already has a part-time posting, and for a part-time consultant at the Rotunda, both in Dublin.

Approval has been granted for a consultant psychiatrist at both Galway University Hospital and Cork University Hospital.

Another two part-time posts “are currently at various stages in the recruitment process”, while plans are in place for four mental health midwives for the National Maternity Hospital, and Kilkenny, Mullingar and Wexford hospitals.