Implementing innovative evidence-based perinatal mental health screening for women of refugee background

Women Birth. 2020 May;33(3):e245-e255. doi: 10.1016/j.wombi.2019.05.007. Epub 2019 Jun 8.

Abstract

Problem: National guidelines recommend repeated screening for depression and anxiety for all women in the perinatal period. Routine screening in pregnancy is limited due to service, community and individual barriers.

Background: Perinatal depression and perinatal anxiety affect up to 20% of all women. Women of refugee background are at even greater risk for perinatal mental health conditions due to refugee experiences and resettlement stressors.

Aim: To evaluate the acceptability and feasibility of a perinatal mental health screening program for women of refugee background from the perspective of health professionals.

Methods: A mixed methods design guided by the Normalization Process Theory was used. Data were collected at a dedicated refugee antenatal clinic in the south-eastern suburbs of Melbourne, Australia. An online survey (n=38), focus groups (n=2; 13 participants) and semi-structured interviews (n=8; 11 participants) with health professionals were conducted.

Findings: Under the four constructs of the Normalization Process Theory, health professionals reported improvements in identifying and referring women with mental health issues, more open and in-depth conversations with women about mental health and valued using an evidenced-based measure. Key issues included professional development, language barriers and time constraints.

Discussion: Implementing a perinatal mental health screening program has been positively received. Strategies for sustainability include professional development and the addition of audio versions of the measures.

Conclusion: This perinatal mental health screening program is acceptable and a feasible option for health professionals. Health professionals value providing more holistic care and have more open discussion with women about mental health.

Keywords: Evaluation; Perinatal mental health; Refugee and asylum seeker; Screening; Women.

MeSH terms

  • Adult
  • Anxiety / diagnosis*
  • Anxiety / ethnology
  • Anxiety / psychology
  • Australia
  • Communication Barriers*
  • Depression / diagnosis*
  • Depression / ethnology
  • Depression / psychology
  • Evidence-Based Medicine
  • Feasibility Studies
  • Female
  • Focus Groups
  • Health Personnel / psychology*
  • Humans
  • Mass Screening / methods*
  • Mental Health
  • Mental Health Services / organization & administration*
  • Perinatal Care*
  • Pregnancy
  • Pregnancy Complications / psychology*
  • Qualitative Research
  • Refugees / psychology*
  • Surveys and Questionnaires
  • Young Adult