Dr. Margo Wrigley:

Assuming those ones still stand, we would like to have additional perinatal psychiatry time for some of these hub hospitals so we can support the spokes in the way I outlined. We have that for the Saolta Hospital Group, but we also need that for the Rotunda Hospital and the national maternity hospital in University College Cork, UCC. Limerick does not have spokes. We also need additional administration staff in at least three of the hub hospitals. As I said, we see them as very important.

Outside our service, in the model of care itself, we have listed the large number of services that are concerned with perinatal mental health. We are looking at a particular aspect of it, but there is much more to do. The areas I would cite would be primary care and psychology, which have been referred to. We would like the public health nursing workforce to be properly expanded to ensure more visits in the way that we have talked about.

There is a need for specific mother and infant attachment services. This is not for the women we see who have significant mental health problems, but there are also women where there may also be attachment problems developing outside that. For instance, where babies have spent a protracted period of time in neonatal intensive care units, that may be a problem. There are also women with, shall we say, personality disorder, who may have attachment problems and could also benefit from those sorts of services as well.

There is the whole area of infant mental health, which takes the child up to the age of three, for which we have no services available in Ireland. They are not developed within our overall child and mental health services. However, they need to be looked at as well.

I am being very ambitious. I am just saying that we have that list. We see ourselves as providing for mild through to severe mental health issues arising in women attending maternity services. We are developing the training and linkages so that others involved, such as GPs, public health nurses and so on, can link into community mental health teams – that side of things. However, there is a huge need for investment in infant mental health. That needs attention.