A new unit has been set up to help women in Wales who experience serious mental health problems during pregnancy and following the birth of their child.
Uned Gobaith (‘Unit of Hope’) will be the only inpatient unit of its kind in Wales to offer multidisciplinary mental health care to women from 32 weeks of pregnancy until their baby is one year old.
Until now, mothers who needed serious mental health care have either been supported in the community, admitted to acute mental health wards without their babies, or have had to travel to one of the specialist mother and baby units in England.
At present, the closest unit for women living in the Swansea Bay UHB area is in Bristol.
Based at Tonna Hospital, near Neath, the new unit is designed to be a home away from home where mums will have access to specialist care for themselves and their babies.
It has six individual bedrooms for women and their little ones. Mums who are admitted will also have access to a shared living room and kitchen areas along with a playroom, quiet room and sensory room.
In addition, accommodation will be available for family members travelling from further away to visit their loved ones.
Supporting the mothers and their babies on site will be a multidisciplinary team that includes psychologists, mental health nurses and psychiatrists, as well as social workers, health visitors and midwives.
Nursery nurses will be on hand around the clock too, to look after babies while mothers rest or receive treatment.
Uned Gobaith was commissioned by the Welsh Health Specialised Services Committee, and made possible thanks to Welsh Government funding and support from mental health specialists in community and inpatient care.
A patient and service user group also gave crucial feedback during the development process, and chose the unit’s name.
Toni Evans, 34, from Port Talbot, experienced serious mental health problems during and after her second pregnancy.
Now a member of the patient group, she believes a local unit like Uned Gobaith would have made a huge difference to her treatment and recovery.
Toni began suffering with depression in 2019 while pregnant with her daughter Sarah.
“It just got worse and worse as the pregnancy went on,” Toni said.
“The depression just got unbearable. I remember ringing my husband on the way to work one day saying that I was going to drive into a wall because I just needed help. Obviously I didn’t, but I just wanted to get out of it.
“Once the baby was born, I started medication straight away, but within two weeks my mental health deteriorated even further.”
Toni was seen by a mental health crisis team and, with the support of her “amazing” midwife, she was admitted to an acute mental health ward.
This type of ward has no facilities for babies or small children so Toni spent three days away from Sarah while she was assessed.
While she was in hospital, a member of the Perinatal Response and Management Service (PRAMS) team (which works with women at risk of developing mental health problems during pregnancy and after birth) told Toni a space was available at a specialist mother and baby mental health unit in Derby.
“At this point I couldn’t really think, I couldn’t answer questions so my husband had to say yes for me,” Toni said.
Toni and Sarah made the daunting 180-mile journey with two chaperones and a driver she had not met before. Arriving at 8pm, she struggled to get her bearings properly in a completely unfamiliar place.
“When we finally got to the unit, I didn’t want the chaperones to leave – they were part of home, they were Welsh, they were from where I’m from,” Toni said.
“I was being left in England, in a different country to where my family was.”
While Toni did make good progress in the seven weeks she was at the unit, the distance between her and Sarah in Derby, and her husband and son at home in South Wales was very hard for them all.
“My husband would come and visit but it had to be every other weekend because he had to take time off work and take my son out of school,” Toni said.
“And it cost a lot of money, driving up there and staying in a hotel.”
If there had been a unit closer to home, Toni believes it would have made a real difference to her family, her recovery and her transition back to home life.
“The people that I was in the unit with were local so they would have visitors a few times a week. I really was on my own up there,” she added.
The distance also meant that Toni went through a different going home process. While other patients would get to go back to their families for a few hours at a time before building up to overnight stays or weekends, Toni travelled to Port Talbot for week-long stays.
She had the support of local mental health specialists but it was hard for her to drop back into home life again.
“That was a difficult transition to go from being in the unit where you are so incubated and then back into the big wide world for a week with the baby and your family and everyday life,” Toni said.
“Some mums would go home for a little bit and it would be too much but they could go back to the unit.
“I didn’t have that choice. I had to travel four hours home and then if I didn’t like it, I’d have to go four hours back.
“It was just more pressure. I didn’t want to make my husband do that trip unnecessarily when he was doing it on weekends. It felt like I should suck it up and get on with it at home.
“It made a big difference to my recovery.”
After seven weeks of support and mental health treatment at the unit in Derby, Toni and Sarah made the journey home for a final time.
That was not the end of Toni’s mental health journey, however. When Sarah was six months old, Toni had a manic episode and went back into hospital for four weeks.
But this time there were no beds available in any mother and baby unit, so Toni was taken to a mixed acute mental health ward – without Sarah.
Right: Toni and Sarah
Toni has since been diagnosed as bipolar and is taking positive steps forward in her mental health journey.
But she feels that if she had been able to go to a unit closer to home, her experience of inpatient treatment would have been “completely different” – and is vital for other mothers’ recovery.
“I think it would have been a lot smoother and I wouldn’t have felt so isolated there. I was missing my son – at the time he was four years old – and my husband.
“I felt like I had taken the baby away from them because they weren’t able to visit,”Toni said.
“A unit here is just going to make an unbelievable difference for mothers in Wales. It definitely would have made a difference to me.”
Uned Gobaith is due to open in mid-April and will be accepting mothers and babies for treatment immediately.
Janet Williams, Associate Service Director of Mental Health and Learning Disabilities at Swansea Bay University Health Board, has been part of the team leading the unit’s development.
Janet said, “When Uned Gobaith opens, we will be able to help women like Toni who are experiencing serious mental health problems, and their babies, in a safe environment much closer to home.
“This important service will significantly enhance perinatal care services across Wales and we are very proud to be hosting it in Swansea Bay University Health Board.
“It will be the only mother and baby unit of its kind in Wales, and its development has only been possible with support from a wide range of experts, teams and patients across the country.”
Minister for Mental Health and Wellbeing, Eluned Morgan, said: “It is fantastic news that we have our own perinatal mother and baby unit in Wales to support those struggling with their mental health.
“This will make a significant difference to the experience of new mothers as they will be able to get the specialist support that they and their babies need closer to home.
“We all know that the pandemic restrictions have added to the challenges during this last year and so I welcome the addition of this facility which will complement our strengthened perinatal community offer.”
Sharon Fernandez, National Clinical Lead for Perinatal Mental Health, said: “The opening of Uned Gobaith is a huge step forward for the treatment of pregnant women and new mothers experiencing severe mental distress.
“Providing this kind of specialised mental and emotional support for women at one of the most vulnerable times in their life is essential, and the family-friendly environment Uned Gobaith offers means that partners and older children can be involved and get the support they need too.
“As a network, we were very pleased to play a role in the development of Uned Gobaith.
“Its opening is a tribute to the hard work and commitment of everyone involved, especially the many women who shared their own personal experiences of perinatal mental health difficulties in order to improve services for others.”