A national survey of psychiatric mother and baby units in England

Abstract

Objective: This study identified all mother and baby units (MBUs) (defined in this study as inpatient psychiatric units where mothers and babies could be admitted that had at least four beds and were separate from other wards) in England and established the operating procedures of MBUs and the clinical characteristics of their inpatients.

Methods: A national cross-sectional survey of alternatives to standard acute inpatient care was conducted in England in 2005. Multiple methods, including telephone inquiries and consultation with relevant experts, were used to identify services. All MBUs identified were contacted and invited to participate in an interview with a researcher.

Results: Twenty-six facilities that accommodated mothers and babies were identified. Thirteen were excluded from the final analysis, because they did not fulfill the study's operationalized criteria for a MBU. Twelve of the 13 facilities with an MBU agreed to participate. Nationally, MBUs had fewer beds than needed and marked geographical variation. Ward size ranged between four and 12 beds, average occupancy was 78%, and the mean length of stay was 56 days. On admission, 45% of women were experiencing psychotic symptoms, and 18% were detained compulsorily. A significant proportion of MBUs did not offer psychological treatments (42%).

Conclusions: The provision of MBUs in England is inequitable, and the clinical and operating characteristics of these services are highly variable. However, this study demonstrated that MBUs are serving women with severe mental illness. If services are to expand and develop in the future, more qualitative and quantitative studies are required to identify the most effective components of MBUs and examine for whom the MBUs are most helpful.