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Published on: August 25, 2014
Post-natal depression screening and treatment in maternity and child health clinics
L Kuosmanen1, M Vuorilehto, S Kumpuniemi
1Primary Health Care Organization of the City of Vantaa, Vantaa, Finland. lauri.kuosmanen@vantaa.fi
Insights
Post-natal depression (PND) affects many mothers, increasing children's risk of depression. A Finnish study found primary care mental health nurses effectively treated PND in over 50% of mothers with brief interventions.
Area of Science:
- Public Health
- Mental Health Services Research
- Primary Health Care
Background:
- Post-natal depression (PND) is a significant mental health issue in Western countries.
- Children of parents with PND face increased risks of developing depression.
- Primary healthcare requires enhanced mental health competencies for maternal and child care.
Purpose of the Study:
- To improve the recognition and treatment of post-natal depression within primary healthcare settings.
- To evaluate the effectiveness of brief mental health nurse interventions for PND.
Main Methods:
- A practice development project in Vantaa, Finland.
- Mothers scoring ≥13 on the Edinburgh Postnatal Depression Scale participated.
- Intervention involved cognitive behavioural therapy-based, goal-oriented sessions with a mental health nurse.
Main Results:
- One to two sessions with a mental health nurse were sufficient for over 50% of 166 participating mothers.
- 68% received PND care within their child's monitoring clinic, avoiding specialized psychiatric services.
- Appropriate use of antidepressant medication was also enhanced.
Conclusions:
- Brief, primary care-based interventions by mental health nurses are effective for post-natal depression.
- Integrating PND care into existing child health clinics improves accessibility.
- Enhanced primary care mental health services can improve maternal and child well-being.
Abstract:
Post-natal depression is a major mental health problem in many western countries. The children of depressed parents face an elevated risk of depression before reaching adulthood. In primary health care, there is an obvious need to improve competence in mental health among those working with mothers and their children. In this practice development project the aim was to improve recognition and treatment of post-natal depression in primary health care in City of Vantaa, Finland. Mothers scoring 13 points or more on Edinburgh Postnatal Depression Scale were asked to participate in a cognitive behavioural therapy-based and goal-orientated session with a mental health nurse. Based on analysis of 166 mothers it can be concluded that one or two sessions with a mental health nurse were sufficient for over 50% of the mothers, and 68% of the mothers were able to get post-natal depression care in the same clinic where their children are monitored without a need for specialized psychiatric services. In addition, the appropriate use of antidepressant medication was enhanced.
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