SAC0074
Written evidence submitted by Dandelion Military Families
Introduction
Dandelion Military Families (CIC) is a new organisation passionate about supporting those navigating early parenthood, mental health, and service life. We believe the impact of poor Service Family Accommodation (SFA) on perinatal mental health is tangible and cannot be ignored anymore.
This letter will outline perinatal mental health, risk factors in terms of service families, and the prevalence of perinatal illness. It will then outline our concerns about SFA and the negative impact we feel the current situation has on perinatal mental health.
Who We Are and Perinatal Illness
Dandelion Military Families (DMF) was formed just under a year ago by military spouses who recognised the lack of support in the perinatal period for service families. The perinatal period is defined by the NHS (2023) as:
‘…during pregnancy or… the first year following the birth of a child’[1].
Our lived experiences and anecdotal evidence from other Service Families, have shown that NHS mental health services often do not understand the challenges of service life, whilst the military offers no specific mental health support for the perinatal period to serving personnel or their families. This leaves service families falling through the cracks.
The Best Start for Life[2] (2021) report states:
‘today, the period from conception to age two is globally recognised as critical for building strong societies’.
The Best Start for Life (2021) report makes it clear that good mental health for parents is a critical factor in good parenting, child health, development, and bonding. Perinatal illness can jeopardise the health of the whole family.
The mental health charity Mind (2023[3]) describes the most common perinatal mental health problems as:
• perinatal anxiety
• perinatal depression
• perinatal obsessive-compulsive disorder (OCD)
• postpartum psychosis
• postpartum PTSD
And that some of the risk factors for perinatal mental health are:
previous experience of mental health problems
• biological causes
• lack of support
• difficult childhood experiences
• experience of abuse
• low self-esteem
• stressful living conditions
• major life events
Many military families will fluctuate in and out of many of these risk factors: lack of support with no local family/friends, poor self-esteem due to losing employment/friends/support through frequent moves. Stressful living conditions from poor housing repairs/quality/availability and major life events such as deployments and house moves. With any of the above risk factors, DMF believes there is an innate vulnerability for services families in the perinatal period.
The Maternal Mental Health Alliance[4] (2023) tells us that 1 in 5 parents experience perinatal mental health problems but that 70% of parents will underplay their mental difficulties. Sadly, suicide is the leading cause of maternal death in the perinatal period.
Yet, the 2023 FAMCAS survey[5] tells us that 25% of service families were unable to access mental health services they needed. This is a worrying statistic when set against the stark reality of how serious perinatal illness can be.
Service Family Accommodation and Perinatal Illness
We need to look at other data sources due to a lack of research in this specific area. The charity Mind[6] (2023) cites stressful living conditions, such as poor-quality housing, as a risk factor in perinatal mental health problems. The impact of poor housing is documented in research by Shelter UK in 2017, demonstrating that 21% of people they surveyed had experienced mental health problems as a result of their housing situation[7]. Although not military specific, it is pertinent to note that poor housing conditions were a risk factor identified as contributory to poor mental health. In addition, those who rented properties were among those who suffered mental health problems more frequently than owner-occupied properties. The current set-up of SFA is that services families are ‘occupiers’, leading to even fewer rights than those who rent and with no control over who administrates repairs or to what standard. To quote a GP from the research:
‘you should be most happy at home and at work, and if you’re not happy in those places… it’s going to lead to anxiety and depression.’
The recent FAMCAS survey in 2023[8] shows that 31% of service families have at least 1 child under age 5, and 79% of service families have at least 1 child under 18 living in their home. Service families are, by and large, of childbearing age, and thus, perinatal health should be a top consideration for the MOD.
DMF believes that providing high-quality, well-maintained and safe housing could substantially impact all service families residing in SFA. However, the FAMCAS survey shows that only 16% of families are happy with the response to requests for repairs/maintenance, and only 21% are satisfied with the quality of the maintenance/repairs. These are disgraceful statistics.
This sub-committee will no doubt have received detailed personal experiences of unsatisfactory SFA, which are unacceptable in their own right. Still, please try to imagine navigating such appalling housing conditions whilst also adjusting to having a new baby, managing your own mental health with difficult-to-access services, often far away from family/friends and possibly with your serving partner away. We can accept that certain aspects of military and service life are unavoidable and cannot be mitigated, but poor housing is not one of them, particularly when it has the potential to compound the challenges of the perinatal period. The military talk about operational effectiveness. If you are serving but know your family is suffering due to housing issues, this will impact operational effectiveness. Families' health and well-being have been ignored for a long time, and it is time that changed. Future Defence Infrastructure Service has failed to bring more human elements to the contract, as described when it launched in 2022.
Conclusion
Military families are vulnerable in the perinatal period, and perinatal illness can have profound, long-lasting implications. Poor quality housing can affect mental health, and a large number of people who reside in SFA’s will experience becoming parents at some stage and the stressors/risks (as well as the joys) that come with that perinatal period.
DMF would like to see:
• Quick, responsive, courteous and high-quality first-time fixes.
• Compassionate, needs-based, easy-to-access support, with the perinatal period acknowledged as a risk factor in assessing the need/urgency of repairs.
• A movement from occupiers towards tenants' rights to provide further protection to service families.
We hope this correspondence has proved insightful, and helps you to appreciate the wider implications of substandard SFA and the ‘unacceptable levels of service’ that military families are exposed to. We would be happy to participate in any further discussion required.
Dandelion Military Families
23 December 2023
[1] National Health Service (2023) NHS England perinatal mental health. [online]. Available at: https://www.england.nhs.uk/mental-health/perinatal/
[2] HM Government (2021) The Best Start for Life A Vision for the 1,001 Critical Days The Early Years Healthy Development Review Report. Crown.
[3] Mind (2020) Postnatal depression and perinatal mental health. [online]. Mind. Available at: https://www.mind.org.uk/media/12435/pnd-and-perinatal-mh-2020-pdf-version.pdf
[4] Maternal Mental Health Alliance (2023) All about maternal mental health. [online]. Available at: https://maternalmentalhealthalliance.org/about-maternal-mental-health/
[5] Ministry of Defence (2023) UK Tri-Service Families Continuous Attitude Survey Results 2023. Ministry of Defence.
[6] Mind (2020) Postnatal depression and perinatal mental health. [online]. Mind. Available at: https://www.mind.org.uk/media/12435/pnd-and-perinatal-mh-2020-pdf-version.pdf
[7] Shelter (2017) The impact of housing problems on mental health. Shelter.
[8] Ministry of Defence (2023) UK Tri-Service Families Continuous Attitude Survey Results 2023. Ministry of Defence.