Ending Perinatal and Infant Mental Health Stigma: Service Providers can lead the Way

In April 2022 the Scottish Government commissioned See Me and the Mental Health Foundation to find out how perinatal and infant mental health stigma affects new and expectant parents and families in Scotland, and what services can do to end this stigma.

It’s a piece of work that’s very much needed – 20% of new mums and 10% of new dads experience mental health problems during the perinatal period, the time from pregnancy through to birth and the first year of a child’s life. Yet despite how common these experiences are, stigma continues to prevent new parents from seeking or receiving help for their mental health.

Diverse experiences

Starting by reviewing past studies on perinatal and infant mental health stigma, we found out just how diverse these experiences can be. Stigma can come from the mismatch between the expectations and reality of parenthood, with new parents struggling to come to terms with feeling distressed at a time that society says should be full of happiness and joy. It can also come from the perception that ‘coping’ with pregnancy and new parenthood makes you a good mum or dad, or from having your experiences dismissed, minimised or normalised when people do try to speak up or seek help.

Stigma can create guilt and shame, leading new and expectant parents to conceal their symptoms. Mums and dads may worry about losing custody of their children or fear emotionally burdening their family. Sometimes, other family members even discourage seeking support or speaking out, fearing the stigma that this could bring to the whole family.

What’s the result? Increased risk of unnoticed and undiagnosed conditions, missed opportunities for early intervention, and direct impacts on infant wellbeing – including increased risk of early delivery, cognitive and developmental delays, and behavioural and attachment problems.

Now, we’re calling on perinatal and infant mental health services to help put an end to this stigma, and ensure that all new and expectant parents and their families are able to access support when they need it.

Support

By supporting parents and their families to recognise and understand their symptoms, listening to and validating their concerns, and creating an environment where parents are empowered to ask for and receive help, services will help to end this stigma.

Our research showed us that healthcare professionals are a vital source of education, with new parents often relying on professionals to help them understand their symptoms as part of a mental illness that can be treated. Trust and connection with professionals can hugely impact a parent’s decision to open up about mental health problems. Initiatives by services to involve fathers and partners can transform this group from the ‘invisible parent’ to understanding that they too are legitimate service users. Services can play a leading role in ensuring an equitable end to stigma for everyone - by taking action to address language barriers, concerns about immigration status, gendered language, financial difficulties, different cultural understandings of mental health and other barriers which hinder parents’ ability to ask for and receive help.

See Me and the Mental Health Foundation have developed a set of seven evidence-based good practice guidelines to support commissioners, providers, and practitioners in perinatal and infant mental health services to take action towards ending stigma. Ranging from inclusive commissioning to peer support, these principles guide services to address stigma at every stage of a person’s journey through perinatal and infant mental health services. They are complemented by a series of case studies that showcase existing good practice in addressing stigma in Scotland, a literature review detailing the evidence underpinning these guidelines, and a list of helpful resources from other organisations.

Existing good practice

When compiling the case studies, we were blown away by the examples of existing good practice in tackling perinatal and infant mental health stigma from all across Scotland. From training initiatives in the NHS to third sector services designed to meet the needs of parents from minoritised communities, good practice in perinatal and infant mental health stigma is already making a difference for families across Scotland – but we know that there’s still more to be done.

Stigma still prevents many parents from asking for or receiving help. It’s time for services across Scotland to take action to understand and address perinatal and infant mental health stigma, to make sure all families get the best start possible.

Access our resources here and share your examples of good practice by emailing info@seemescotland.org.

Vicky Moynihan is See Me’s project officer for health and social care.