在20世纪末，自杀被列为导致孕产妇死亡的主要原因(CEMD, 2001)。2015年，政府承诺在未来五年内将3.65亿英镑用于英格兰的孕产妇精神卫生专业服务。这是在《精神卫生五年展望》(2016年精神卫生工作组)中提出的。根据这份报告，这些资金将用于“特别关注解决不平等问题”(2016:3)。在此之前，有研究表明，孕产妇自杀并不因逆境或社会经济阶层而受到歧视(Oates, 2003);最近的许多发现表明情况恰恰相反。正如政府的报告所建议的，澄清这一问题是提供相关的公共健康战略以对抗孕产妇精神健康的关键。NICE指南是基于证据的英格兰健康和护理建议。根据NICE(2018)的报告，投入在围产期心理健康方面的3.65亿英镑已经在NHS预算中被锁定，这意味着它必须专门用于这一目的，这样到2021年，每年将有额外3万名妇女能够获得孕产妇心理健康治疗。尽管如此乐观,“人们普遍认为当前提供照顾围产期心理健康问题是全国高度可变,在覆盖和质量”(鲍尔等2014)当时计划高度批评,许多相信更多的国家资助不一定会保证妇女更多的物理服务——或者要花的钱最极其需要的地方。
At the close of the 20st century, suicide ranked as the leading cause for maternal death (CEMD, 2001). In 2015, the government pledged £365 million to be spent over the next five years on specialist maternal mental health services in England. This was set out in The Five Year Forward View for Mental Health (Mental Health Taskforce, 2016). According to this report, the money is to place a “particular focus on tackling inequalities” (2016:3). Previously, research has stated that maternal suicide does not discriminate on the grounds of adversity or socioeconomic class (Oates, 2003) however; many recent findings suggest that the opposite is the case. As the government’s report suggests, clarifying this issue is key in providing a relevant public healthy strategy to combat maternal mental health.NICE guidelines are evidence-based recommendations for health and care in England. According to NICE (2018), the £365 million invested in perinatal mental health has been ring-fenced within the NHS budget, meaning it has to be spent specifically on this purpose, so that by 2021 an additional 30,000 women each year should be able to receive maternal mental health treatment. Despite this optimism, “it is widely acknowledged that the current provision of care for perinatal mental health problems is highly variable around the country, both in coverage and in quality” (Bauer et al 2014a) At the time the plans were highly criticised, with many believing that more national funding would not necessarily guarantee more physical services for women – or the certainty that the money would be spent where it is most vitally needed .
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