Following research from LSE and the Maternal Mental Health Alliance, we chatted with pregnancy and postpartum psychotherapist, Sophie Harris, to learn more about the support available for new and expectant mums

Research conducted last year by the London School of Economics and Political Science, commissioned by the Maternal Mental Health Alliance, revealed the devastating impact that perinatal mental health problems have on women and their families when not effectively treated. What’s more, the former 2014 report calculated that perinatal mental illness costs the UK £8.1 billion annually.

Since 2014, the UK has invested in specialist services provided by the NHS to transform the lives of expectant women with complex mental health problems and their babies. As welcome as these findings may be, more action is now required to see that women and their families receive the quality of care that they need

Whilst improvements have been made, access to perinatal mental health services is still a challenge. The report highlights the long waiting lists for mental health services, including those provided through the NHS Talking Therapies programme (previously known as 'Improving Access to Psychological Therapies' or IAPT). Not only this, but many of the services are unable to meet pregnancy and parenting-specific needs. This means some women don’t accept referrals, miss appointments or are dissatisfied with their treatment.

With more maternal mental health problems being identified as a result of the pandemic, now has never been a more important time to ensure services can respond to increasing demands and are fit for purpose.

The outcomes from the LSE report propose a better integration of perinatal health services, such as maternity and health visiting, with primary mental health services. The collaborative efforts will help address maternal wellbeing and support the early developmental needs of children. This, coupled with identifying women in need and facilitating access to treatment, will have a clinically cost-effective role in society.

We chatted to pregnancy and postpartum cognitive behavioural therapist, Sophie Harris to find out more.

Do you find the findings from the 2014 report surprising?

“Absolutely not,” Sophie says. “Not only are the impacts of maternal mental health difficulties felt by the mother, but also of their child, and potentially even their children. At the moment, there are a lot of unsupported mothers who are struggling. Unfortunately, our children feel our stress. Untreated mental health conditions will have a huge social, emotional and financial impact both on the needs of the mother and child and wider society.”

Do you welcome this research?

“Yes. I believe that any research that highlights the need for maternal mental health support is positive. However, it requires significant action for the impact of these findings to be shown in the outcomes of care for our mothers who are struggling.

“There appears to be a large-scale underestimation of the mental health needs of new mums. For example, the NHS website states that one

Intergenerational trauma can feel like an unrelenting trap, but it’s time to break free

The generations who raised us invariably have a huge impact on our lives, and the people that we become. As adults, we may find a lot of joy in noticing that we have adopted, for example, our mother’s sense of humour, our grandfather’s agreeableness, or our aunt’s passion. But there’s another side to this coin.

There’s a saying you might have heard of: ‘Hurt people hurt people.’ It’s a very simplistic way of talking about the way that one person’s pain can, often completely unintentionally, affect others. And when it comes to the way this manifests in family relationships, it turns into a well-documented psychological phenomenon.

“Intergenerational trauma is defined as trauma that is transferred from one generation of trauma survivors on to the second, and further generations, through genetics and experiences,” counsellor Melanie Kirk says. “This means that even though the original trauma may not have been experienced first-hand, the feelings, symptoms, and behaviours can live on.”

The trauma can be personal, – for example, the parent might have experienced abuse, been the victim of a serious crime, or have suffered loss or bereavement. Or, the trauma could be shared – Melanie points to the example of Holocaust survivors.

“In 2015, a psychiatry and neuroscience professor called Dr Rachel Yehuda directed a team of researchers, and conducted a study on the descendants of Holocaust survivors,” she explains. “It was discovered that the descendants had low levels of cortisol (the hormone that is released during times of stress, which helps to bring down the high levels of adrenaline released when a ‘fight or flight’ response is triggered).

“It was concluded that if one parent has experienced PTSD then future generations may be more likely to inherit the gene adaptation caused by a traumatic event. This in turn could result in the descendant being more susceptible to conditions such as depression and anxiety. Comparable studies were also carried out on the survivors and descendants of 9/11, which revealed similar results.”

What does intergenerational trauma look like?

In the same way that trauma will present differently from person to person, intergenerational trauma does, too. It’s a complex experience, and one that is best explored with the help of a mental health professional. That said, there are common themes.

Besides the genetic impact that Melanie previously explained, if the parent has experienced the trauma, it may affect the way that they interact with their child – they may find it more difficult to regulate their emotions, or to model appropriate coping behaviours to their children. In practice, this may look like a reduced tolerance to stress – perhaps finding they become overwhelmed or angry quickly – or they may find it more challenging to express love and affection. All this may then affect their children’s behaviour and coping mechanisms, and the way they go on to parent, or treat the

With almost one-quarter of parents of children under the age of 11 claiming that the cost of living has had a detrimental effect on their mental health, we take a further look and highlight some available support

Findings from a recent Save the Children/YouGov survey, covered by iNews show how rising living costs are impacting children in the UK physically and mentally. Nearly one-quarter (24%) of the parents surveyed say they are worried about their children’s mental health and one-fifth (17%) of those parents claim their children are suffering from physical health problems. Children living in households with an income of £30,000 or less are the worst affected, with 37% of parents saying their children’s mental health has been affected.

The online survey of 2,008 parents of children aged 11 and under highlighted some of the concerns parents are coming up against due to increased financial pressures. To cut back, parents are finding it difficult to keep up with days out and after-school clubs. And soaring household bills mean parents are buying cheaper food options with less variety. It also means families are living in colder, poorer conditions. This is negatively impacting the overall wellbeing of children; they are more likely to suffer from an increased number of colds and experience reduced sleep quality, for example.

The same survey revealed how parents are even turning down work or are being forced to cut working hours due to expensive childcare. Over half (54%) of mothers have cut their hours because they can’t afford to pay for childcare.

Becca Lyon, head of child poverty at Save the Children UK is calling on the Chancellor, Jeremy Hunt, to take action at tomorrow’s Spring Budget, urging the government to provide further support for struggling families.

“Parents are trying everything they can to put their children first, skipping their own meals, going without heating and their own essentials, but it’s clear families feel their young ones are suffering in such tough financial times.

“Jeremy Hunt should increase child-related benefits, alongside introducing childcare reforms that will support parents back into work.”

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Why do we feel so much pressure to be self-reliant, and how come it is so hard to accept a helping hand? Columnist Michelle Elman delves into our curious obsession with independence, and the life-changing realisation that allowed her to welcome support

We live in a culture that encourages us to be strong and independent, but is it possible that we have gone too far? When there is so much pressure to do everything yourself, is it any wonder that we associate weakness with relying on other people?

Alongside the ‘strong independent woman’ trope that has been sold as an aspirational goal, I believe part of what has caused this is the fearmongering around being ‘codependent’. Codependency was defined by Melody Beattie, in her book Codependent No More, as “one who has let another person’s behaviour affect [them] and who is obsessed with controlling that person’s behaviour.”

Of course, codependency brings its own set of problems, but have we run so far away from codependency that we are now on the opposite end of the spectrum: hyper independence?

Hyper independence is the belief that you are the only person you can rely on. It is often born out of a trauma where you have relied on someone in the past and been let down, so, as a result, you have a “if you want something done, you have to do it yourself” mentality. Consequently, instead of understanding that relying on others is not only normal, but necessary, you feel shame for not being strong enough to go it alone.

I used to be the same. The thinking behind my behaviour was that if I relied on someone, asked them for help or even just a favour, that made me vulnerable, and when you are vulnerable you are exposing yourself to being hurt. What I ignored was that the immense pressure I put on myself to do everything alone was incredibly isolating and, in fact, blocking me from forming genuine and intimate connections, because in order to ask for help, you need to allow yourself to trust others and let them in. And yes, that’s scary! But it’s worth it.

I tell the story in which I learned this myself in my new book, The Selfish Romantic. I had just come back from a funeral when the guy I had been on three dates with checked up on me to see how I was. Being so used to being single, and very hyper independent at that point, I shut down the conversation and said he didn’t need to worry, to go out with his friends, and I’d speak to him the next day. Hours later, he turned up at my door simply saying: “I thought you might want a hug,” and he was right. I really did.

Later that night, I said to him that it was really kind of him, but he didn’t have to come over and that I would have been fine. His response? “I know you would have been fine, but just because you can do it alone doesn’t mean you have to.” It taught me a valuable lesson to not only ask for what you need, but it was actually OK to ask if you didn’t need it, but you simply wanted it. I didn’t need a hug, I would have survived without one, but I sure did want one!

Letting someone in is terrifying. I was right, letting people in gives them potential to hurt you and use your vulnerability against you. But living a life where you don’

It’s time to take a hard look at the reality faced by many in the community

“I’m from the north-west of England, a little town called Morecambe Bay, not far from the Lake District. My family are Showmen Travellers. My mam, she grew up around the Bolton area and her family all had fairgrounds and travelled around the whole of the UK. My dad, he actually came originally from a circus and fairground background. They met and hit it off – not initially, but they got there. And then they decided to have an amusement arcade, so they settled.”

I’m speaking to Xenna Kaser, a counsellor who is also part of the GRT (Gypsy, Roma, Traveller) community. GRT is an umbrella term for those who belong to minority ethnic groups such as Irish and Scottish Travellers, and Romany people, as well as New Travellers, Showpeople, and Boaters. It’s estimated that there are around 300,000 Travellers in the UK, and those in the GRT community share a distinct, diverse, and rich heritage.

“We all went through school still going to those fairgrounds, the big ones in particular, throughout the year to meet friends and socialise,” Xenna continues. “Neither I nor my two brothers have gone into the field. We’ve all gone on to do different things, but are still very much in touch with our background.”

Xenna’s vocation as a counsellor working with the GRT community is an incredibly valuable one. Alongside the everyday joy that comes with family and community, Travellers are one of the most persecuted and marginalised groups in our society. In fact, it was only in 2021 that ‘Roma’ was included as an ethnic group, and ‘Showman’ as an occupation and ethnicity, in the England and Wales Census. And while there is a severe lack of legal sites for Travellers, in 2022, the controversial Unauthorised Encampments: Police, Crime, Sentencing and Courts Act made residing with a vehicle on land without permission a criminal – rather than a civil – offence, giving police the power to seize vehicles and, consequently, people’s homes and way of life. With all that in mind, it goes without saying that living in this environment can take its toll.

The suicide rate for Travellers is six times the general population

That’s according to a study by All-Ireland Traveller Health, and the figure rises to seven times the general population for men. Another survey found that 82% of the Travellers surveyed had been personally affected by suicide.

“I’ve known people who have taken their own lives, and it’s really devastating,” Xenna says. “I think there are a number of factors behind it. One, is that it’s a relatively closed community and it is very misunderstood – so I think people who are having problems, if they were to go to a doctor or a therapist who hasn’t been briefed on the community and how the community works, they could feel quite misunderstood and, therefore, that leads to a lot of shame.”

Xenna’s insight rings true. In January 2019, the Government published its first-ever cross-government Read more