Approaches to health-care provider education and professional development in perinatal depression: a systematic review

Abstract

BackgroundPerinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of educational and professional development needs and strategies for health-care providers in perinatal depression.MethodsA systematic search of the literature was conducted in seven academic health databases using selected keywords. The search was limited to primary studies and reviews published in English between January 2006 and May/June 2015, with a focus on perinatal depression education and professional development for health-care providers. Studies were screened for inclusion by two reviewers and tie-broken by a third. Studies that met inclusion criteria were quality appraised and data extracted. Results from the studies are reported through narrative synthesis.ResultsTwo thousand one hundred five studies were returned from the search, with 1790 remaining after duplicate removal. Ultimately, 12 studies of moderate and weak quality met inclusion criteria. The studies encompassed quantitative (n = 11) and qualitative (n = 1) designs, none of which were reviews, and addressed educational needs identified by health-care providers (n = 5) and strategies for professional development in perinatal mental health (n = 7). Consistently, providers identified a lack of formal education in perinatal mental health and the need for further professional development. Although the professional development interventions were diverse, the majority focused on promoting identification of perinatal depression and demonstrated modest effectiveness in improving various outcomes.ConclusionsThis systematic review reveals a lack of strong research in multi-disciplinary, sector, site, and modal approaches to education and professional development for providers to identify and care for women at risk for, or experiencing, depression. To ensure optimal health outcomes, further research comparing diverse educational and professional development approaches is needed to identify the most effective strategies and consistently meet the needs of health-care providers.Trial registrationA protocol for this systematic review was registered on PROSPERO (Protocol number: CRD42015023701), June 21, 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1431-4) contains supplementary material, which is available to authorized users.

Public health nurses’ perinatal mental health training needs: A cross sectional survey

“…However, 63.8% of PHNs reported the need for additional skills development for assessment of perinatal mental health. Symptoms of perinatal depression and anxiety have the potential to overlap with those of perinatal transitions making accurate detection a challenge (Legere et al, ). Further training can support the contextualization and use of existing knowledge and experience to underpin effective clinical decision‐making (Jones et al, ).…”

“…Participants who had a personal experience of PND highlighted the need for further education to address the stigma associated with PMHPs. Professional training has the potential to offer a mechanism to support PHNs to explore their own personal attitudes to mental health to address underlying assumptions, negative, and stigmatizing beliefs (Legere et al, ; Markström et al, ). Providing opportunities to explore prevalence of mental health issues amongst healthcare professionals themselves and the impact of their non‐disclosure may improve attitudes towards mental health problems (Gras et al, ).…”

“…Seventy per cent of PHNs reported that they had insufficient access to information which may be explained by the finding that just over half of PHNs had access to policy/guidelines and there are currently no national guidelines relating to perinatal mental health available. Legere et al, () contend that guidelines can offer a resource to enhance healthcare professional's confidence, attitudes, and knowledge and support a consistent approach to education and perinatal mental healthcare provision. Our findings lend support for the development of additional continuous professional development opportunities to assist PHNs in their role.…”

“…Our findings lend support for the development of additional continuous professional development opportunities to assist PHNs in their role. Limited access to continuous professional development opportunities can have a negative impact on levels of knowledge and awareness of perinatal mental health while on the other hand training for healthcare professionals has been noted as an effective strategy in the prevention of PMHPs (Legere et al, ). Effective training has potential to promote consistency in the implementation of evidence‐based practices including screening, which in turn creates greater equity in access to perinatal mental health services for women and their families (Henderson et al, ; Morrell et al, ).…”

“…However, e‐learning offers advantages in terms of cost, ease of dissemination, flexibility and resources (Morrell et al, ), and web‐based courses have been found to be effective in supporting nurses to use more evidence‐based approaches for postpartum emotional distress (Ingadottir & Thome, ). There is evidence that interactive teaching approaches provided through more than one session can positively improve the confidence levels of healthcare professionals to provide perinatal mental health care to women and their families (Higgins, Carroll, & Sharek, ; Legere et al, ). Short sessions on perinatal mental health have also been linked to improved knowledge and confidence in care provision (Jones et al, ).…”