Sweet Mother: evaluation of a pilot mental health service for asylum-seeking mothers and babies

Purpose - This paper aims to describe the evaluation of an innovative pilot mental health service for asylum seeking mothers and their babies in their first year of life, and to highlight the challenges and possibilities when intervening with this group. Design/methodology/approach - A mixed-methods evaluation was designed based upon the participatory action research framework, viewing mothers and their infants as active participants in the research process. Evaluation comprised reflective infant-led session evaluations, CARE Index video microanalysis, and reflective focus group discussions. CARE Index analysis was conducted by a trained Psychologist and an external coder to ensure reliability of findings. Focus group discussions were thematically analysed, and reflective infant-led session evaluations scored for comparison. Findings - Evaluation has highlighted the imperative of designing responsive service models able to adapt to cultural nuances and the realities of asylum seekers' lives. Qualitative data provide a rich narrative of the benefits of therapeutic interventions for this group, which are reaffirmed by CARE Index analysis and session evaluations. Research limitations/implications - As a pilot service the numbers involved in this evaluation are small. Furthermore, a paucity of measurement tools validated in languages other than English forced reliance upon self-designed tools such as the reflective infant-led session evaluation designed to complement a "keeping the baby in mind'' ethos of the intervention. This has been complemented by CARE Index analysis and qualitative focus group discussions. The combination of measurement instruments and data analysis tools provides a comprehensive indication of the impact of this pilot intervention. Practical implications - The benefits and challenges of establishing an early-intervention therapeutic service for refugee and asylum seeking women and their infants are detailed and reflected upon. It is hoped that by chronicling the experience and findings an evidence base is being built to support development of future innovative service models. Social implications - Policy aspirations to meet the needs of refugee and asylum seeking women and their infants identify the need to provide rights-based, humane and person-centred services. The pilot model described here meets these aspirations and can be used as an adaptable and responsive model upon which other services can draw. Originality/value - The paper provides a comprehensive service evaluation, highlighting key policy and practice implications to support the delivery of health and social care services targeting refugee and asylum seeking women and their infants.