Assessment of specialist health visitors’ contribution to perinatal and infant mental health

Abstract

Infant’s emotional well-being is shaped largely by their primary attachment relationship and the sensitivity and the quality of their interactions within that relationship. Parental psychosocial adversity is a significant risk factor for disturbances in the parent-infant relationship and infant emotional, behavioural, eating and sleeping disorders, and up to 20 per cent of women develop a mental health problem during pregnancy or within a year of giving birth. 

Specialist Health Visitors in Parent Infant Mental Health (SHV in PIMH) are local-level leaders in promoting perinatal and infant mental health with post-registration specialist training in promoting healthy caregiving relationships between parents and infants. Specialist health visitors constitute 0.8% of the workforce, of which SHV in PIMH are a minority.

The role of a specialist health visitor can include providing training, consultation and support of health visitors and other professionals working with mothers, direct clinical intervention to a specialist caseload of families with higher levels of need (referred to them by health visitors, social care workers, midwifery, obstetricians, GPs and mental health service), and advocacy on behalf of specialist infant-parent services in conversations with commissioners and providers.

Despite broad agreement about the role of SHV in PIMH, there is great variability in the job description for specialist health visitors across the country and while a growing number of health visiting services have PIMH champions who have completed the specialist health visitor training to be qualified as a SHV in PIMH, only a small minority of health visiting services have created an official specialist health visitor post. 

Given the lack of clarity regarding the unique contribution of specialist health visitors, and why there is such variability in commissioning this position, this research will examine these issues further using an online survey with SHV in PIMH, in addition to in-depth interviews to explore in more detail, some of the issues raised in the survey.