Perinatal Mental Health Toolkit by the Royal College of General Practitioners
Up to one in five women and one in ten men are affected by mental health problems during pregnancy and the first year after birth. Unfortunately, only 50% of these are diagnosed.
Without appropriate treatment, the negative impact of mental health problems during the perinatal period is enormous and can have long-lasting consequences on not only women, but their partners and children too. However, this is not inevitable. When problems are diagnosed early and treatment offered promptly, these effects can be mitigated.
This toolkit provides a set of relevant tools to assist members of the primary care team to deliver the highest quality care to women with mental health problems in the perinatal period.
Source: Perinatal Mental Health Toolkit
We know a mom who is clinically depressed has a lot of negative outcomes. Those negative outcomes are not just for the mom, they can also have long-term implications for children.
Researchers and clinicians alike have been particularly concerned about the effects of maternal depression during and after pregnancy on children.
But a new study suggests that a mother’s depression during the preschool years may be more harmful to children than either her prenatal or immediately postnatal depression. It is the first study to track the effects of maternal depression on children from pregnancy until the children turn 5.
Domestic violence is any physical, sexual, psychological or economic abuse that takes place between people who are sharing, or have recently shared a home.
In Africa, there is more violence against women than on any other continent. Three women are killed by their partners in South Africa every day, thats twice as many women than in the United States of America. Violence during pregnancy has negative effects for both the mother and the child. Abused women are more likely to delay getting pregnancy care and to attend fewer antenatal visits.
Our recent research study looked at pregnant women who experience domestic violence in Hanover Park, Cape Town. We looked at the profile of women who reported domestic violence and what factors in their lives were associated with this abuse.
We found that women who were experiencing domestic violence were more likely than those without domestic violence to:
– have a current mental health problem like depression, anxiety, suicidal thoughts or behaviours, alcohol or drug abuse
– have had past mental health problems
– have experienced past abuse
– not feel supported by their partner
– not likely feel pleased about being pregnant
– more likely experience food insecurity and not have a job
Out of this study with developed a learning brief which targets any service providers who interact with vulnerable women and children, especially those service providers who work with pregnant women. Such services providers can arise from nongovernmental organisations (NGOs) or civil society organisations and may be healthcare providers or social service providers.
Find this and more on our resources for professionals pages.
While perinatal mood and anxiety disorders (PMAD) have a global footprint, the majority of research related to this group of illnesses has come largely from more affluent, Westernized countries. Similarly, the tools used to detect and screen for PMADs were developed and tested in these Westernized countries.
The instrument most commonly used to detect PMADs is the Edinburgh Postnatal Depression Scale (EPDS), which was originally developed in Great Britain. While it has been translated into many different languages and used in many different countries, it is unclear if these translated versions of the EPDS accurately identify PMAD in disparate, non-English speaking countries. Specifically there has been concern that simply translating the EPDS may not fully capture the cultural determinants of mood and anxiety disorders.
Particularly vulnerable to mental health problems are the women who are pregnant or have recently given birth living in resource-constrained, low- and lower-middle-income countries (LALMICs) as defined by the World Bank. A recent systematic review appraised formally validated local language versions of the EPDS used in resource-constrained settings (Shrestha et al., 2016).
Mental health care in South Africa has been chronically underfunded for many years, which is reflected in inadequate care in primary clinics, community residential care facilities and acute mental health units in district and national hospitals, says Professor Crick Lund.
Lund, director of the Alan J Flisher Centre for Public Mental Health (CPMH) in UCT’s Department of Psychiatry and Mental Health, issued a statement in the wake of the Health Ombudsman Professor Malegapuru Makgoba’s report into the deaths of more than 94 mentally ill patients from Life Esidimeni in Gauteng.
Health Ombudsman Prof Malegapuru Makgoba’s report into the deaths of more than 94 mentally ill patients from Life Esidimeni in Gauteng elicited an outcry when it was released this week
Integrating therapy, other services, or information into routine visits can make getting help easier and chip away at the stigma regarding postpartum depression.
Unlike the “baby blues,” which are commonly associated with mild feelings of worry and fatigue after having a baby, postpartum depression is a mood disorder characterized by a broad range of symptoms including anxiety, extreme sadness, and exhaustion.
We are starting the New Year with a poignant reminder by the Medicated Mommy blogger.
“I consider myself lucky. Maybe not lucky to have gone through the debilitating experience of postpartum depression (although looking back I am grateful–more on that in my next post), but fortunate enough to have recognized something was very wrong within 48 hours of being home from the hospital with my son. Upon this realization… The help I needed came in many different forms during my struggle that first year.”
In our last newsletter of the year we’ve thanked you, our supporters, families and friends who believed in the work we do and supported us throughout 2016.
With your donation of expertise and money we were able to care for mothers in need and engage with those providing health and social support for them.
Enjoy this festive season and we are looking forward to an even more exciting 2017 with you!
In this newsletter we are highlighting some of the achievements of the previous two months. Happy reading.
What is empathic engagement and why is it important?
Empathy is the ability to perceive the meaning and feelings of another person and to be able to communicate these to that person. Empathy is a core aspect of building relationships and positive client interaction. When care workers engage empathically with clients, clients feel empowered, service uptake is improved and clients are more likely to adhere to recommended interventions and treatment regimens. There are also benefits for the care workers who report less burnout and enhanced work satisfaction.
Studies have shown that empathic engagement does not necessarily take up more time, is not emotionally exhausting like being sympathetic, and does not overburden the care worker, as the client maintains responsibility for their own problems. In addition, this type of communication can actually save time, effort and expense as the relevant client issues are more quickly identified resulting in early and more effective management.
Building up to empathic skills: learning about maternal mental health
Stigma, related to a lack of understanding and negative stereotyping of those with mental illness, is a significant factor in communities and among care workers. We attempt to reduce this stigma through the provision of background information about maternal mental illness and related medical and social problems. We encourage participants to work in small groups, engage with, discuss and apply our training material in a way which is relevant to their unique situations and work environment.
We noted a gap between the perceived ability and actual ability of workshop participants to engage empathically. Most participants struggle to “listen” and accept the client’s perspective without judgment. Instead, they very quickly assume they understand the problem and revert to “telling” and “fixing” based on their own perspective and experience.
Read more on how to develop a meaningful training, how to support trainers and how to evaluate the training process in our Learning Brief
A number of new studies have found that stress, depression or anxiety during and after pregnancy can have long lasting effects on the development of your child.
We have translated some of those findings into an Issue Brief and added some of our recommendations for evidence based interventions for parents.
This Issue Brief outlines not only the risk factors for parents, but also encourages the building of resilience to prevent or lessen the negative impacts for children.
“Caring for mothers and fathers – is caring for the future”