It was a sunny spring evening on Tuesday 16^th April 2024 when Professor Fiona Alderdice gave a Professorial Lecture in the Council Chamber, Lanyon Building, QUB. Fiona is the Senior Social Scientist, NPEU and Co-Director NIHR Policy Research Unit in Maternal and Neonatal Health and Care, University of Oxford. She is also a Senior Research Fellow, Harris Manchester College and honorary Professor School of Nursing and Midwifery, Queen's University Belfast. The title of the lecture was 'Perinatal Mental Health: There can be no health without mental health.' In attendance were members of Fiona's family and friends who joined colleagues from education, health and social care, and third sector organisations across Northern Ireland.

The phrase ‘there can be no health without mental health’ has been attributed to the first Director-General of the World Health Organisation (WHO) and very much reflects the broad definition of the health given by the WHO in 1948: ‘A complete state of physical, mental and social wellbeing and not simply the absence of disease or infirmity’. However 76 years later this definition is still aspirational. Perinatal mental disorders are the commonest complication of childbearing and yet mental health care continues to languish in the shadow of physical health care around the time of birth. Fiona highlighted that over the past decade progress has been made however many challenges remain.

One of the key challenges in perinatal mental health is understanding the complex relationship between mental health and pregnancy and childbirth. Fiona emphasised the importance of listening to people with lived experience. She then explored what women tell us about their mental health around the time of birth from her research using the National Maternity Surveys. These surveys are conducted at the National Perinatal Epidemiology Unit at the University of Oxford where Fiona is based. They provide the most reliable data on common mental health problems around the time of birth in England.  The last survey which was during the COVID-19 pandemic, showed a big increase in the number of women with symptoms of depression after giving birth and it is really important for us to know if these numbers are continuing to increase or not.

Coming back to the WHO definition of health at the end of the lecture, Fiona discussed the value of looking at the whole spectrum of psychological wellbeing from mental disorder through to flourishing. By building on the whole spectrum of wellbeing we have an opportunity to re-define how we thing about mental health. This approach could help confront stigmatising attitudes and behaviours, promote simple interventions that help parents flourish, while promoting early detection of and support for mental health problems. On concluding, Fiona emphasised that it is not enough to simply focus on physical health around the time of birth or the absence of illness. We need to explore ways that we can help all women and their families flourish.

Below are a selection of Professor Alderdice's Publications:

• Ayers S, Sinesi A, Coates R, Cheyne H, Maxwell M, Best C, McNicol S, Williams LR, Uddin N, Shakespeare J, Alderdice F. When is the best time to screen for perinatal anxiety? A longitudinal cohort study. J Anxiety Disord. 2024;103:102841.
• Fellmeth G, Kanwar P, Sharma D, Chawla K, DasGupta N, Chhajed S, Chandrakant, Jose EC, Thakur A, Gupta V, Bharti OK, Singh S, Desai G, Thippeswamy H, Kurinczuk JJ, Chandra P, Nair M, Verma A, Kishore MT, Alderdice F. Women's awareness of perinatal mental health conditions and the acceptability of being asked about mental health in two regions in India: a qualitative study. BMC Psychiatry. 2023;23(1):829.
• Harrison S, Quigley MA, Fellmeth G, Stein A, Alderdice F. The impact of the Covid-19 pandemic on postnatal depression: analysis of three population-based national maternity surveys in England (2014–2020). The Lancet Regional Health - Europe. 2023;15:100654.
• Harrison S, Pilkington V, Li Y, Quigley MA, Alderdice F. Disparities in who is asked about their perinatal mental health: an analysis of cross-sectional data from consecutive national maternity surveys. BMC Pregnancy Childbirth. 2023;23(1):263.
• Webb R, Uddin N, Ford E, Easter A, Shakespeare J, Roberts N, Alderdice F, Coates R, Hogg S, Cheyne H, Ayers S. Barriers and facilitators to implementing perinatal mental health care in health and social care settings: a systematic review. Lancet Psychiatry. 2021;8(6):521-34.
• Alderdice F. Supporting psychological well‐being around the time of birth: what can we learn from maternity care? World Psychiatry 2020 19 3 https://doi.org/10.1002/wps.20778