2002 International International Biennial Scientific Meeting

REVIEW OF SYSTEMATIC ANTENATAL SCREENING FOR MENTAL HEALTH PROBLEMS IN PREGNANCY

Deborah Wilmoth and Jonathan Rampono

Department of Psychological Medicine for Women, King Edward Memorial Hospital, Subiaco, Western Australia

Deborah.Wilmoth@health.wa.gov.au

Most women are in frequent contact with health professionals during pregnancy and childbirth (Holden, 1994). This provides the opportunity for women at higher risk of developing postnatal depression to be identified and provided with prevention or treatment services. However, before identification and prevention can occur, effective methods for performing these assessments are required.

The objective of this paper is to present the model of service delivery developed to implement an antenatal screening which involved a collaborative effort between the Obstetric Clinical Care Unit and the Department of Psychological Medicine for Women at King Edward Memorial Hospital.

Intervention: King Edward Memorial Hospital - KEMH - is a women's public teaching hospital of 110 beds. There are approximately 25,000 births in Western Australia annually and approximately 5,000 of these births occur at King Edward Memorial Hospital. The concern arose to identify these women prior to the development of the symptomatology for postnatal depression. In order to do this, it was decided that the Antenatal Clinics at KEMH would begin administering the Edinburgh Postnatal Depression Scale (EPDS) to all women presenting for the first time at any of the clinics.

Method: To handle this increased work load in an efficient and effective manner as possible, clinical pathways were developed to facilitate the patient's entry, course and discharge from the Department.

Preliminary Results: The establishment of pathways clinically improved the service delivery of the Department of Psychological Medicine for Women at King Edward Memorial Hospital when a screening program was introduced into the hospital system. The pathways also enabled the Department to gather the type of data necessary to justify and increase in its staff resources to cope with this influx of referrals.

Conclusions: Indeed serious and important, it is generally agreed in principal that a proactive approach to the early identification and treatment of women at risk of such a severe disorder is necessary.