A systematic review of interventions for healthcare professionals to improve screening and referral for perinatal mood and anxiety disorders

Abstract

Postpartum depression affects approximately 11% of women. However, screening for perinatal mood and anxiety disorders (PMAD) is rare and inconsistent among healthcare professionals. When healthcare professionals screen, they often rely on clinical judgment, rather than validated screening tools. The objective of the current study is to review the types and effectiveness of interventions for healthcare professionals that have been used to increase the number of women screened and referred for PMAD. Preferred Reporting Items for Systematic Reviews and Meta-Analyses was utilized to guide search and reporting strategies. PubMed/Medline, PsychInfo/PsychArticles, Cumulative Index to Nursing, Allied Health Literature (CINAHL), and Health Source: Nursing/Academic Edition databases were used to find studies that implemented an intervention for healthcare professionals to increase screening and referral for PMAD. Twenty-five studies were included in the review. Based on prior quality assessment tools, the quality of each article was assessed using an assessment tool created by the authors. The four main outcome variables were the following: percentage of women screened, percentage of women referred for services, percentage of women screened positive for PMAD, and provider knowledge, attitudes, and/or skills concerning PMAD. The most common intervention type was educational, with others including changes in electronic medical records and standardized patients for training. Study quality and target audience varied among the studies. Interventions demonstrated moderate positive impacts on screening completion rates, referral rates for PMAD, and patient-provider communication. Studies suggested positive receptivity to screening protocols by mothers and providers. Given the prevalence and negative impacts of PMAD on mothers and children, further interventions to improve screening and referral are needed.

Engagement with perinatal mental health services: a cross-sectional questionnaire survey

“…Regardless, the results suggest that women need to be proactively engaged in a meaningful experience during the screening process, and educated on the rationale for further assessment and treatment. Goldin Evans et al [33] and Long et al [34] found that screening rates increase if HCP are educated about perinatal mental health, emphasizing the need for health services to increase mental health literacy amongst HCP. This would also improve health literacy amongst women and their social supports, potentially facilitating increased emotional support.…”

Describing the Nature and Correlates of Health Service Providers’ Competency Working With Sexual and Gender Minority Patients: A Systematic Review

“…The quality of each article was assessed using an 18-item assessment tool created by the author based on a prior assessment tool of quality in the literature (Long et al, 2019). See the online supplement to review the assessment tool.…”

Perinatal Anxiety and Depression During COVID-19

“…Additionally, the use of simulation educational interventions for healthcare professionals using standardized patients is another factor that improves screening, treatment, and ultimately improves maternal and child health. 36 …”