An evaluation of routine antenatal depression screening and psychosocial assessment in a regional private maternity setting in Australia

Kalra, Harish; Reilly, Nicole; Austin, Marie-Paule

doi:10.1111/ajo.12777

Cited by 17 publications

(40 citation statements)

References 18 publications

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“…However, the qualitative design of the study and the inclusion of a range of healthcare professionals ensured that the critical role they play in providing holistic health care to women in a regional area was both recognised and respected . Women’s perspectives were not explored within this study; however, their comfort and acceptability of the program have been previously reported …”

Section: Discussionmentioning

confidence: 99%

“…An integrated psychosocial model of care, comprising routine administration of the Antenatal Risk Questionnaire (ANRQ) and Edinburgh Postnatal Depression Scale (EPDS) at a woman’s first antenatal booking visit, was introduced at the participating site in April 2015, and included localised protocols for referral for additional assessment or support as required. This program has achieved a participation rate of nearly 90% …”

Section: Methodsmentioning

confidence: 99%

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Insights into implementation of routine depression screening and psychosocial assessment in a private hospital setting: A qualitative study

Reilly

Brake

Kalra

et al. 2019

Aust NZ J Obst Gynaeco

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Background Studies continue to show that women who give birth in the private maternity sector are less likely to receive depression screening and psychosocial assessment as a routine component of maternity care. However, examples of successfully implemented routine psychosocial assessment programs are beginning to emerge, and there is great value in better understanding the factors that can contribute to the successful delivery of emotional health care in this context. Aim The aim of this study was to identify factors that facilitated successful implementation of antenatal psychosocial assessment in a private hospital setting. Methods This study employed a qualitative research design. Semi‐structured interviews were used to explore the views and experiences of health professionals involved in implementation of the program at the participating site. Results Nine health professionals participated in the study (three midwives, three obstetricians, two managers and one mental health worker). Factors that facilitated successful implementation of the program were reflected in five key themes: (i) multidisciplinary support for the program; (ii) training and clinical supervision; (iii) allocation of sufficient resources; (iv) availability of local referral pathways; and (v) normalisation of the process. Conclusion This study shows that barriers to implementation of perinatal depression screening and psychosocial assessment are surmountable and will provide confidence to other services, that routine ‘mental health assessment’ as required under updated Medical Benefits Scheme items for obstetric services, can be successfully implemented and sustained in private hospital settings.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Insights into implementation of routine depression screening and psychosocial assessment in a private hospital setting: A qualitative study

Reilly

Brake

Kalra

et al. 2019

Aust NZ J Obst Gynaeco

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“…Based on the increasing international move to standardise as routine the psychosocial assessment and depression screening of all pregnant women and offer relevant support [40][41][42], different options need to be considered in order to enhance psychosocial care. Some of the interventions that are applied in certain countries globally are reflected in Table 2.…”

Section: Qualitative Findingsmentioning

confidence: 99%

Psychosocial Antenatal Care: A Midwifery Context

Mathibe-Neke¹,

SuzanMasitenyane²

2019

Selected Topics in Midwifery Care

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The rationale of any national screening programme is to recognise the benefits for public health, to assess a predominantly healthy population including pregnant women and to detect risk factors for morbidity in order to provide timely care interventions. The focus of antenatal care screening is to identify wider determinants of health that may have an impact on a pregnant woman's well-being that includes the physical, psychological, social and religious factors. Psychosocial risks, among others, include poor socioeconomic conditions such as poverty, lack of social support, general health inequalities, domestic violence and a history of either personal or familial mental illness, all of which have the capacity to influence a pregnant woman's decision to utilise health care services. This chapter highlights the antenatal care process, the importance of psychosocial care during pregnancy, maternal risks during pregnancy, the impact of pregnancy on maternal well-being, the possible psychosocial risk factors during pregnancy, psychosocial assessment, psychosocial care as a missing piece of the antenatal care puzzle, the presentation of the results of a study on psychosocial risk assessment and support and further outlining various antenatal care approaches that could be adopted to offer pregnant women holistic care.

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“…Two studies of private hospitals that had implemented an assessment program demonstrated high levels of acceptability [19,26]. One of the focus group participants explained that as women are under the care of an obstetrician prenatally the midwives may be restricted in the assessment they can conduct.…”

Section: Part Of Routine Carementioning

confidence: 99%

“…The comprehensive assessment of risk of mental illness as part of routine, coordinated perinatal care has been demonstrated to be feasible and highly acceptable in the private hospital setting [26,43] and should be available to all women who give birth in a private hospital.…”

Section: Recommendationsmentioning

confidence: 99%

Perinatal Assessment of Risk of Mental Illness: Experience of First-time Mothers and Clinicians, Australian Private Hospitals

Sims

Fowler

Catling

et al. 2019

Preprint

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Background The many changes in becoming a mother increase the risk of developing a mental illness in the perinatal period. Comprehensive, psychosocial assessment for risk of mental illness is recommended as part of routine perinatal care for all women. In Australia, this assessment was less likely to be undertaken for women who gave birth in a private hospital compared to women who gave birth in a public hospital. Therefore this study aimed to explore the experience of perinatal assessment of risk of mental illness for first-time mothers who gave birth in a private hospital. Method The results are from an explanatory mixed-methods study on the risk of the development of a perinatal mental illness and its relationship with the delivery of, or lack thereof, a parenting support service. Interviews were conducted with first-time mothers, midwives, nurses, obstetricians and paediatricians at two Australian metropolitan private hospitals. Content analysis of the interview data provided exploration and interpret their experience of assessment of risk of mental illness. Results Interview data were gathered from 32 participants. Four themes on assessment of risk of mental illness for these women were described: part of routine perinatal care; comprehensive psychosocial assessment; coordination between care providers and lack of mental health resources. Conclusion For mothers who gave birth in a private hospital, comprehensive psychosocial assessment of risk of mental illness may not have been provided as part of the routine perinatal care and not coordinated between care providers. A lack of mental health resources cannot be regarded as a barrier to provision of these services.

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An evaluation of routine antenatal depression screening and psychosocial assessment in a regional private maternity setting in Australia

Cited by 17 publications

References 18 publications

Insights into implementation of routine depression screening and psychosocial assessment in a private hospital setting: A qualitative study

Insights into implementation of routine depression screening and psychosocial assessment in a private hospital setting: A qualitative study

Psychosocial Antenatal Care: A Midwifery Context

Perinatal Assessment of Risk of Mental Illness: Experience of First-time Mothers and Clinicians, Australian Private Hospitals

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