The consequences of maternal mental illness can be debilitating and intergenerational, setting up a vicious cycle reinforcing both poverty and mental illness.
Untreated mental distress in the mother can increase vulnerability to
- HIV infection
- substance abuse
- the impacts of poverty and other hardships
- her experiencing violence from intimate partners
- loss of employment
- decline in health due to decreased access to health services
- obstetric complications
Depression and anxiety
Untreated depression and anxiety in the mother affects the physical, neurological and behavioural development of the infant and child.
Consequences can include
- negative impacts on foetal brain development
- increased crying and irritability in the infant
- disruption of the mother-infant bond
- early cessation of breastfeeding
- non-completion of immunisation regimes
- higher rates of infectious illness and hospital admission
- gastro-intestinal problems or diarrhoeal disease
- poor nutrition
- decreased motor skills
- delayed growth or stunting
- long-term behavioural and emotional problems
- infant mortality
Psychiatric disorders and suicide
Psychiatric disorders and suicide are a leading cause of maternal mortality in developed countries.
In developing countries, mental illness decreases access to antenatal care, is consistently associated with infant mortality, and is a significant risk factor for loss of developmental potential in children under 5 years.
Addressing the mental health needs of the mother clearly has positive implications for the wellbeing of women, their children and families, and long term social development.
Untreated mental illness may lead to social and psychological problems among women, such as vulnerability to violence and abuse, drug or alcohol dependency, HIV infection, the breakdown of family relationships and social exclusion or alienation due to stigma.
Women from disadvantaged communities who experience mental health problems face the economic costs of untreated mental illness, including
- increased health expenditure
- loss of income linked to reduced productivity
- impaired functioning
- increased absenteeism
- lost employment
For these reasons, the relationship between poverty and mental illness are said to interact in a ‘vicious cycle’.
In addition to economic impacts, the disability associated with depression can have serious consequences for the children of mothers with mental illness. Maternal mental disorders are strongly associated with poor obstetric outcomes, such as preterm delivery and prolonged labour. Research shows that hormonal changes in the womb, brought about by mental illnesses, can affect the foetus with negative implications for childhood development. Maternal depression and anxiety are also strongly linked with lower educational levels in children.
It is clear that when mothers are not treated for mental illness, there are significant, broader health and development outcomes for themselves and their families. These outcomes are directly linked to the underachievement of many of the Millennium Development Goals (MDGs).
Specifically, in South Africa, MDG4 outcomes (reduce mortality of children under five years) have worsened, and MDG5 outcomes (improve maternal health by reducing maternal mortality per 100 000 live births by 75%) have not improved.
View a summary of the intergenerational impacts of maternal mental illness in this Issue Brief.