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“Perinatal services are definitely the future and Family Action is ahead of the game….offering something completely unique in terms of volunteered delivered services”

Professor Jane Barlow, Warwick Medical School

Maternal depression can turn into a lifelong illness if not responded to and it is proven to increase risks to the unborn child and the safe development of the new baby.

Supporting the mother (and father as well as other family members where possible) and the developing infant through this period is recognised to be a key time for intervention in order to mitigate the negative outcomes.

Failure to fully address perinatal mental health problems carries a total economic and social long-term cost to society of over £8 billion for each one-year cohort of births in the UK, according to a report ‘The costs of perinatal mental health problems’ by the London School of Economics and Centre for Mental Health. The report finds this cost to the public sector is five times greater than the cost of providing the services that are needed throughout the United Kingdom.

Family Action is a member of the Maternal Mental Health Alliance which commissioned this report as part of its ‘Everyone’s Business’ campaign. The campaign calls for all women throughout the UK who experience perinatal mental health problems, to receive the care they and their families need, wherever and whenever they need it.

A recent report produced by Pro Bono Economics into the potential economic benefits of Family Action’s Perinatal Support Services shows there is evidence of a wide range of short and long term benefits for the women themselves, their children and society at large.

The services can deliver financial benefit of around £2,430 for each woman receiving support – rising to £4,383 if the monetisation of wellbeing is included. The long term benefits could be considerably more if the beneficial effects on children are taken into account.

“Perinatal services are definitely the future and Family Action is ahead of the game….offering something completely unique in terms of volunteered delivered services”

Professor Jane Barlow, Warwick Medical School

Our services

The Family Action Perinatal Support Services are early intervention, low intensity services for those with low to moderate level diagnosed mental health issues or who are at risk of developing perinatal mental illness. The services are led by a professional project co-ordinator, with an early years, health or social care background, and provided by a team of volunteer befrienders  who have experience of parenthood and sometimes have received help from the service themselves.

We work with families from before the baby is born to at least one year after.

Taking a multi agency approach, we work closely with midwives, health visitors, GPs, Children’s Centres and existing perinatal teams to enhance what is available to families where mothers are suffering with mental health difficulties. Safeguarding, training and regular supervision of volunteers are key standards.


  • The service is well placed in primary care because of the close access to GPs, health visitors and midwives.
  • It can work alongside the Family Nurse Partnership (FNP) pathway as a complementary, wraparound service or as a tier-down service. It is also able to work with women who do not meet FNP criteria: i.e. those over 19 and/or are having their second child.
  • The coordinator can provide an in reach service to a mother and baby hospital and provide early advice and guidance, introducing the peer supporter following discharge.
  • The service is also well-placed in children’s centres to enhance early year’s provision and work as part of multiagency team, engaging vulnerable families in interventions from the earliest stages.

The volunteers:

  • Offer mother regular emotional support to reduce social isolation and to help mum be more emotionally available for her baby and other family members
  • Observe how the mother responds to her baby and offer guidance on how she can better relate to and parent her baby
  • Help the mother take the baby and other children outside of the home so they can access services they need – i.e. health services, shops, parks and children’s centres
  • Give the  mother support with issues which concern them, for example by signposting to organisations that can help with benefits and housing,
  • Are managed by a professional project coordinator
  • Are assessed by the coordinator on each referral with regular reviews

Like a Mum to me – a mother’s account of postnatal depression and working with Family Action

“It’s not always easy becoming a mum and it isn’t just becoming a mum for the first time that can seem very daunting. For me it was my third time.

In the run up to giving birth everything was lovely, we were all very excited and ready to meet the new arrival. Everything went smoothly at the birth and my baby boy was healthy.

After a couple of days I started to feel the baby blues. I had the same overwhelming emotions with my other two children after they were born so when the health visitor came I told her. I just believed her when she said it would soon pass.

But weeks seemed to pass and it wasn’t budging. With each day that passed the emotions would just get worse and the anxiety I would feel would put a stop to everything. I would just stay in, I didn’t want to go anywhere and I felt like a failure – the worst mum ever.

When the health visitor came to see us again I told her everything, just hoping that she might have some magic cure that would make it all stop. She was very understanding and she suggested a referral to the Family Action Perinatal Project.

As the date came closer for a perinatal worker to visit, I couldn’t believe I was going to let a stranger into my house with me in the mess I was in. But I needn’t have worried; she was so lovely and reassuring.

After a long chat she suggested attending a small group where there would be other mums with similar struggles from around the area I live in. I wasn’t keen at first and there were so many things that seemed to be in the way of me attending. I didn’t feel like going out for a start and the thought of leaving my little one in the crèche just made me feel even more like a bad mum. But I was reassured once again that everything would be fine and that she would even meet me outside the building before so that I didn’t have to go in alone. So I agreed to give it a go.

At first it was very difficult. My confidence was at an all time low, and I was so worried about meeting others and them just thinking I was a freak. After the first week I didn’t even think I had the strength to go back, but I did and with each week that passed I started to enjoy going and my confidence started to grow, little by little with the encouragement and support that was given.

It didn’t seem to matter that I was struggling with my mental health and I was made to feel human again. A human that just needed help and there was no shame in that. I also received home visits from Julie (perinatal worker), which really helped me to feel like I had someone who understood what my struggles were and she helped me work through them.

She was a friend to me when I had no one and kept me focused on what was important (my boys) when my depression was overwhelming.

I don’t really want to think if things had been different, but I know I wouldn’t be where I am now without the Perinatal Project. I still sometimes struggle from day to day, but now I am armed with coping strategies and have also made two friends from attending the support group. My boys have also made friends with the other parents’ children from the group. The whole experience has also inspired me to become a volunteer, so that I can give something back and also get out and meet other adults – hopefully helping them combating their isolation.

For me the project has not only been the hand that brought me out of the darkness, but also the hand that wiped my tears, held me up when I was weak and encouraged me to just to be me. It has been like a Mum to me.

A huge thank you to the Perinatal Project and all that have been involved in working with me and my boys.

My experience - words from a befriender

In January 2010, I was diagnosed with a tumour which I had to have removed through major thoracic surgery and to cut a long story short, at the end of 2010, I took redundancy from my job due to these ongoing health issues.

Fast forward to the end of 2013, my health began to improve, so thoughts turned to getting back in to the workplace. In February 2014 I started working a couple of days per week. Unfortunately I was laid off in July 2014 so reluctantly I took myself off to the Job Centre. I was shocked to be told I hadn’t paid the right kind of NI contributions, so couldn’t claim Job Seekers Allowance! All of a sudden I was in a position where I had nothing to lose. I could either choose to pursue the same kind of work as I had done for so many years – or go in a totally different direction – a career change. I quite easily decided on the latter because ever since my first son was born (almost 22 years ago) I’ve wanted to be a midwife.

I learned that as part of making that a reality, I would have to demonstrate experience of working in a relevant area – and my previous work hadn’t been.

I started searching for voluntary work and through Sure Start was signposted to Family Action who were looking for volunteers for one of their Perinatal Services at the time. Excellent and relevant experience for my university application!

Following an interview, I began my training in September 2014.

Having received the initial training (which incidentally was some of the best training I’ve experienced), I gained valuable insight into the perinatal service and what it means to the people it supports. We provide vulnerable mothers and families with someone to turn to, someone to talk to – give them something to look forward to, someone to trust and it gives them hope. As befrienders, we help them feel listened to and supported and treat them like they matter and aren’t just a number.

In return we get free training and development, experience and opportunities. However, the biggest reward is knowing that you’ve made a difference to those who use the service. Making them feel like someone is investing time in them in turn improves their mental health and wellbeing – all of which makes a difference to their outlook and their attachment to their child or children, and has a knock on effect on their well-being and development.

The difference we make is actually measureable in terms of their ‘star score chart’, and knowing that our little contribution makes a positive change to those outcomes is nothing short of wonderful.

Around Christmas time, one of my befriendees contacted me to tell me that her little boy said ‘mama’ for the first time.  She was so excited, and so was I because she chose me to be one of those she shared that with. I can’t tell you how rewarding that was – you just can’t put a price on something like that.

Knowing that I have the support of the Family Action team means I can do this little thing for someone. My coordinator provides direction, support, back up but most of all, she provides us with opportunities. These opportunities are invaluable for personal development or for finding paid employment. It also helps to gain new skills and experience, all of which will enhance my C.V. and increase my chances of moving into this, or similar areas of work. The training and matching up with my family has certainly done wonders for my confidence, which was knocked a little when I had to give up work.

I am enjoying the role so much that I am currently matched with 2 mums with small infants. Knowing that someone looks forward to my visit is very humbling and that does a lot for one’s own sense of worth. I am also currently helping to facilitate on a parenting course, and hope to go on and actually deliver this myself in the near future.

You will get out of this experience what you put in, and more. Most of all, you can make a difference to someone in need, someone who is experiencing something which most of us are quite fortunate never to have experienced.

I have found it becomes less about taking and more about giving.

Our impact

There is considerable, independent evidence that Family Action’s Perinatal Support Services are effective in terms of positive outcomes for service users, babies, and volunteers, as well as being cost effective to run – the financial benefit of the service exceeds the cost to run it.



In 2012 Professor Jane Barlow of Warwick Medical School carried out an independent evaluation of Family Action’s Perinatal Support Services across the country. She reported:

  • 88% of service users who have been followed up show a reduced score for anxiety and 59% show a reduced score for depression on the HAD (Hospital Anxiety and Depression) scale.
  • 47% of service users who have been followed up show a higher level of social support on the MSSI (Maternal Social Support Index) Scale.
  • There is a significant improvement in mother-baby warmth
  • Befrienders report that they have gained in confidence from volunteering. A significant number of volunteers, on leaving the project, are going on to employment, education or training.

A previous randomised control trial of the service carried out by a Guys, Kings and St Thomas researcher in South London found the Perinatal Support Project halved the rate maternal depression.

Most recently Pro Bono Economics demonstrated that the service is effective in reducing post-natal depression and there is evidence to link this effectiveness to a wide range of short and long term beneficial outcomes affecting the women themselves, their children and society at large.

The quantified benefit of Family Action PSP is estimated to be £2,429 for each woman who receives support and rises to £4,383 if the monetisation of well-being is included. These benefits could be considerably more in the longer term if the beneficial effects on children are taken into account.

Perinatal Support Service Outcome Triangle

Perinatal Evaluation 2012 by Professor Jane Barlow

Southwark Newpin Perinatal Evaluation

PBE Family Action report Oct 2014

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Email: [email protected]
Telephone: 020 7254 6251