Written evidence submitted by the University of the West of Scotland (CMH0081)
Consultation: Community Mental Health
Introduction
At the University of the West of Scotland (UWS) we research the link between menstruation and mental health of women and people who menstruate. We have the UK’s largest portfolio of funded research on Premenstrual Dysphoric Disorder (PMDD), a severe mood disorder characterised by debilitating psychological symptoms and suicidality. We collaborate with researchers across the UK, exploring the wide impacts of PMDD. To date we have studies funded by Research England, ESRC Impact Accelerator Fund, Medical Research Scotland, the UWS Crucible Initiative, and the Royal Society of Edinburgh. A key finding from our research is the dearth of appropriate support within community mental health services, and lack of PMDD training/knowledge for health professionals in those services. We launched the UK’s first research agenda for PMDD, co-developed with UK stakeholders, and we have provided multiple training sessions on PMDD for health professionals (e.g. the Transformation of Care programme which was disseminated to all mental health services in NHS England). We have explored PMDD within wider services such as the welfare benefits system. We are in the process of launching a medical student curriculum toolkit for PMDD alongside other funded studies. We liaise in policy fields, with networks with the Scottish Government’s Women’s Health Plan, Cross Party Group for Women’s Health, the Welsh Women’s Health Coalition and more. We hope our input is helpful in strengthening community mental health services.
Dr Lynsay Matthews
Lecturer in Public Health
Researcher, Women’s Mental Health
University of the West of Scotland
What does high-quality care look like for adults with severe mental illness and their families/carers?
How could the service user journey be improved both within community mental health services and in accessing support provided by other services/agencies?
It is crucial that the menstrual cycle is factored into mental health services that support women and people who menstruate. Premenstrual Dysphoric Disorder (PMDD) is a severe hormone-based mood disorder characterised by debilitating psychological symptoms and suicidality. It impacts approximately 1 in 20 [1], of which 1 in 3 attempt suicide and more than half self-harm [2]. It should be a core component to assessment when supporting women and people who menstruate within mental health services. The UK’s first research agenda for PMDD [3] highlighted that diagnosis and management of PMDD was lacking in the UK. As part of our UK wide consultation, health professionals identified the need to “ask the right question”, such as “how often does this happen?” or “has this happened before?” and/or “when is your next period due?”. These simple questions can help identify patterns. This was highlighted by our stakeholder input where: (i) paramedics identified patterns when arriving to support women who had self-harmed; and (ii) A&E staff nurses who asked ‘did this happen last month?’ etc.
How could this be measured/monitored locally and nationally?
Formal, standardized tracking of the menstrual cycle, and answers to menstrual related questions are critical to ensure that support of women and people who menstruate is optimal. Menstrual cycle tracking is the key diagnostic tool available for Premenstrual Dysphoric Disorder (and Premenstrual Exacerbation of other mood disorders) [4] and should be measured and monitored nationally as standard practice
How can community mental health services work with social care, the third sector and local government to better address service users’ health and wider social needs that are wider determinants of mental health outcomes?
Our research on Premenstrual Dysphoric Disorder (PMDD) has highlighted cross-overs with other services. Interim findings from our study of PMDD and the welfare benefits system identified a lack of trauma-informed practices for Adult Disability Payment (ADP; Scotland) and Personal Independence Payment (PIP; England, Wales and Norther Ireland) [5]. This leads to the people most in need of support facing significant barriers to support, and leading to increased trauma and harm, and potentially leading to increased burden on community mental health services.
Our innovative research on mothers with PMDD identified that PMDD has a complex impact on parenting, with concerns related to the early years development of young children [6]. This has an impact on multiple services who engage with mother with PMDD, including health visitors, social services, early years practitioners and more. However, a lack of awareness, knowledge and training on PMDD within these services makes it challenging for mothers and families in need of support to be identified and appropriately supported. These are important considerations for community mental health service. s
How could the funding system be reformed to more effectively drive transformation in the delivery of integrated and person-centred community mental health services?
It should align with the current women’s health strategies in Scotland, Wales and England [7-9], to prioritise funding for women (and people who menstruate) who are most in need. The combined strategies highlight priority areas such as menstrual cycle related disorders (e.g. Premenstrual Dysphoric Disorder), women from minority ethnic groups, those in vulnerable situations such as domestic violence and/or substance use etc. These are priority areas for funding and upskilling of professionals in community mental health services.
References
[1] Reilly TJ, Patel S, Unachukwu IC, Knox CL, Wilson CA, Craig MC, Schmalenberger KM, Eisenlohr-Moul TA, Cullen AE. The prevalence of premenstrual dysphoric disorder: Systematic review and meta-analysis. J Affect Disord. 2024 Mar 15;349:534-540. doi: 10.1016/j.jad.2024.01.066
[2] Eisenlohr-Moul T, Divine M, Schmalenberger K, Murphy L, Buchert B, Wagner-Schuman M, Kania A, Raja S, Miller AB, Barone J, Ross J. Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder. BMC Psychiatry. 2022 Mar 19;22(1):199. doi: 10.1186/s12888-022-03851-0
[3] Matthews, L., & Riddell, J. (2025). Premenstrual Dysphoric Disorder (PMDD): The UK Research Agenda. University of the West of Scotland. https://doi.org/10.5281/zenodo.14644017
[5] Campbell, M., Matthews, L., Riddell, J., & Harkess-Murphy, E. (2025). Interim report. Premenstrual Dysphoric Disorder and the welfare state: recommendations for reform. University of the West of Scotland. https://doi.org/10.5281/zenodo.14644134
[6] Matthews, L., Fallow, C., Gollek, C., Harkess-Murphy, E., & Ingram, J. (2025). Premenstrual Dysphoric Disorder (PMDD): Insight from mothers with PMDD. University of the West of Scotland. https://doi.org/10.5281/zenodo.14773037
[7] Scotland Women’s Health Plan https://www.gov.scot/publications/womens-health-plan/
[8] Women’s Health Strategy for England https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england
[9] Women’s Health Plan for Wales https://executive.nhs.wales/functions/networks-and-planning/womens-health/the-womens-health-plan-for-wales/
February 2025