Risk and resilience: a mixed methods investigation of Aboriginal Australian women’s perinatal mental health screening assessments

Abstract

Purpose To describe the psychosocial protective and risk factors for perinatal mental health identified in a sample of Aboriginal women’s Kimberley Mum’s Mood Scale (KMMS) assessments and explore the role of these factors in their screening assessment and diagnostic outcome. Methods We used a mixed methods approach to retrospectively analyse a cross-sectional study dataset of 91 completed KMMS assessments. This included: categorising the clinical notes from the KMMS psychosocial yarn into ‘risk’ and ‘protective’ factors and describing these categories, describing the number and type of risk and protective factors associated with different KMMS risk assessment categories (no, low, medium, high), and exploring relationships between these risk and protective factors and diagnosis of perinatal depression and/or anxiety. Results Protective factors were recorded for the vast majority of the women; the most prominent was positive family relationships. When protective and risk factors were stratified by KMMS risk category, women in the higher risk group less commonly had specific protective factors (11–33% high vs 61–100% no risk) and more commonly had risk factors (22–67% high vs 6–28% no risk) than women with lower KMMS assessed risk. The average number of protective factors decreased with increasing KMMS risk category (4.9 ± 1.1 to 1.6 ± 1.3), with the inverse pattern for risk factors (1.1 ± 1.1 to 3.8 ± 1.0). Having protective factors also appeared to reduce the risk of developing clinical depression or anxiety. Conclusion Assessing protective factors in mental health screening for perinatal Aboriginal women increases the effectiveness of screening and provides a foundation for the delivery of local structured psychosocial care.

Exploring Mental Health Presentations in Remote Aboriginal Community Controlled Health Services in the Kimberley Region of Western Australia Using an Audit and File Reviews

“…The results of this study indicate that interaction between the ACCHS and a patient increases when the patient is experiencing significant risks or stressors, and/or if chronicity is a factor. These findings are congruent with other Aboriginal and Torres Strait Islander mental health research that articulate the role of psychosocial risks, many related to the social determinants of health [22], in the presentations of Aboriginal distress [12,[23][24][25][26]. Violence within families, interpersonal conflict, and insecure or inappropriate housing were common antecedents, or attendants, to mental health presentations.…”

Mixed-methods study exploring health service access and social support linkage to the mental well-being of Canadian Indigenous pregnant persons during the COVID-19 pandemic

“…The WHO (2015) reports that community support and engagement is largely impactful to positive outcomes among pregnant people. Social support, specifically partner support, has been cited as a resiliency factor for pregnant individuals, particularly those with high-risk pregnancies 26 41 42. Social support during the prenatal period can mitigate adverse mental well-being outcomes for pregnant individuals, and subsequently, developmental outcomes for their babies, such as low birth weight 22 36 41.…”