#MHForAll webinar: Mother and Child Mental Health
On Tuesday 29th November, 2022, our #MHForAll webinar series brought together a panel of experts to discuss the importance of integrating mental health support, specifically perinatal mental health (PMH) care, into existing maternal and child health services. Our panel included:
Laura Ochoa Foschini - Bernard van Leer Foundation (Bernard van Leer Foundation)
Neerja Chowdhary - World Health Organisation
Terna Abege - Save the Children Nigeria
Melanie Picolo - PATH, Mozambique
Anne Sylvie Ramelet - Partnership for Maternal, Newborn and Child Health
Laura Fitzgerald - USAID MOMENTUM
Replay the session:
Session notes
The session chair, Laura Ochoa Foschini of BvLF, highlighted the importance of addressing perinatal mental health. Laura explains that 1 in 5 women in LMICs experience mental health symptoms in pregnancy and right after birth. Adolescent mothers, women living in poverty and humanitarian contexts, women exposed to domestic and gender-based violence and living with disability and pre-existing mental health conditions are at a greater risk of developing mental health symptoms.
Laura highlights that mothers that experience mental health challenges can struggle to build nurturing environments for children and as a result, poor maternal mental health can directly impact the health and development of children.
BvLF has supported the development of the WHO’s latest publication on
integrating PMH into maternal and child health services.
The WHO guide lists recommendations on how service-providers, administrators and policy-makers can develop high-quality, integrated mental health services for perinatal care. These recommendations can be adapted according to the resources and funding that is available in different contexts and also outlines a stepped-care approach that can be developed to suit the varying needs of mothers in the perinatal period.
WHO Technical Officer, Dr Neerja Chowdhary shared three key messages from the publication:
Treating perinatal health improves the mental and physical health of the mother, and has the potential to improve child health and development outcomes
There are evidence-based interventions for the prevention and management of PMH conditions
These interventions can be provided by trained non-specialist healthcare workers
In Mozambique, the Ministry of Health is showing an appetite for upscaling the integrations of PMH care in existing maternal health services, says Melanie Picolo of PATH. Though this approach is still very new, PATH has been working in collaboration with the Ministry to pilot new screening and counselling support systems for mothers in South Mozambique.
Maternal and child health nurses were trained to screen mothers for postpartum depression and provide counselling during routine postnatal care services. The data produced shows that intervention was successful and over 70 percent of suspected cases of PPD referred by MCH nurses were confirmed by mental health technicians.
Terna Abege of Save the Children Nigeria, explains that the introduction of standardised screening tools and counselling services has also had a significant impact on the mental health of mothers living in humanitarian settings in Northeast Nigeria.
In this region, once a diagnosis has been made, treatment plans designed by mental health professionals are issued to patients, and include psychoeducation and group counselling.
Mothers receive a minimum of 5 sessions to discuss their mental health and issues such as suicidal ideation and follow-up meetings are arranged to monitor their progress and provide additional support. There is evidence that counselling sessions are leading to an improvement in thinking patterns and mitigating emotional distress, says Terna.
The concept of respectful care, which is referenced in the WHO guide, must be considered when integrating PMH care into existing maternal health services, says Anne-Sylvie Ramelet of PMNCH. When patients are treated as equals, the quality of care that is provided improves. She flags that screenings of risk factors are only possible and effective when professionals take their time when talking to the mother and to caregivers.
New research shows that up to 40% of mothers who face long-stays in the NICU after their child is born experience PTSD and neonatal units have programs to support the uncertainty of this journey. Inter-professional collaboration is especially important in this respect, as family-centred care nurses and paediatricians must be aligned and well-equipped to provide this level of care.
Cross-sectoral collaboration and collective engagement is a key component in driving forward the national and global agenda to integrate PMH into maternal and child health services, says Laura Fitzgerald of USAID MOMENTUM.
The organisation has developed a global PMH Theory of Change with efforts led by experts in diverse fields and backgrounds and include women with lived experience, funders, researchers, implementers and representatives from local non-governmental organisations and representatives from global agencies.
The Theory of Change is a shared common structure that has been organised according to the socio-ecological model, with a multi-layered framework focusing on the interpersonal, community, service-delivery ecosystem and also the national policy levels.
At each level of this spectrum there are suggested evidence-based interventions that are known to be effective and can be adopted and implemented by other organisations and entities working in this space.
MOMENTUM Country and Global Leadership invites you to join the new community of practice for PMH in LMICs. The PMH community of practice is a space for passionate individuals committed to improving the PMH outcomes in LMICs. If you would like to be involved or like more information, please contact: Anam Bhatti, Technical Development Officer (anam.bhatti@jhpiego.org).
Links/resources:
Thinking Healthy manual.
Learn more about USAID Momentum’s work on Maternal and Newborn Health.
Highlights from the maternal mental health Technical Consultation in 2021.
Learn more about PATHS’s work on Maternal and Newborn Care here.
Learn more about PMNCH’s programmes here.
ICN publishes new report on mental health nursing workforce.
Council of International Neonatal Nurses, Inc. (COINN) Position Statement on ‘Keeping babies and their parents together’.