How rates of perinatal mental health screening in Australia have changed over time and which women are missing out

Moss, Katrina M.; Reilly, Nicole; Dobson, Annette; Loxton, Deborah; Tooth, Leigh; Mishra, Gita D.

doi:10.1111/1753-6405.12999

Cited by 26 publications

(26 citation statements)

References 30 publications

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“…In the last decade, several national initiatives have been introduced including the NPDI to improve prevention and early detection of antenatal and postnatal depression. However, screening coverage for expectant mothers remains suboptimal with one in five mothers who have reported emotionally distressed during pregnancy were not being screened both antenatally and postnatally as recommended by clinical practice guidelines [ 71 ]. Of those who were screened, almost two in five perinatal Australian women (38.9%) were not comfortable with enquiry about their depression or anxiety symptoms.…”

Section: Discussionmentioning

confidence: 99%

Perceived social support on postpartum mental health: An instrumental variable analysis

Inekwe

Lee

2022

PLoS ONE

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The postpartum period is a challenging transition period with almost one in ten mothers experiencing depression after childbirth. Perceived social support is associated with mental health. Yet empirical evidence regarding the causal effects of social support on postpartum mental health remains scarce. In this paper, we used a nationally representative panel data of women to examine causality between perceived social support and postpartum mental health. We used fixed-effect method and included dependent variable lags to account for past mental health condition before birth (i.e., the pre-pregnancy and prenatal periods). The study also used an instrumental variable approach to address endogeneity. We find a declining trend in postpartum mental health between 2002 to 2018. Our study also showed that past mental health (i.e., before childbirth) is positively correlated with postpartum mental health. A universal routine mental health screening for expectant and new mothers should remain a key priority to ensure mental wellbeing for the mothers and their infants.

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Section: Discussionmentioning

confidence: 99%

Perceived social support on postpartum mental health: An instrumental variable analysis

Inekwe

Lee

2022

PLoS ONE

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“…While actions at this level will have little impact on the political and social structures that generate social hierarchy, they may help prevent the generation of further inequalities and we recommend that action is taken to mitigate future effects on already disadvantaged families. We focused on research conducted in the UK, but detection and treatment disparities by ethnicity, age, parity and SES have been reported in other countries that recommend universal perinatal screening such as the US and Australia [49][50][51], are likely ubiquitous, and require similarly urgent attention.…”

Section: Implications For Policy and Practicementioning

confidence: 99%

Inequalities in the identification and management of common mental disorders in the perinatal period: An equity focused re-analysis of a systematic review

et al. 2021

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Objective Maternal mental health problems in the perinatal period can cause significant distress and loss of functioning, and can have lasting impact on children. People living in disadvantage are at risk of health inequalities, including for perinatal mental health. A review of current guidance found that overall implementation of the UK detection and management strategy was satisfactory, but equity was not considered in the review. Greater understanding of implementation equity is needed. We aimed to reanalyse an existing systematic review on the implementation of current guidance for the identification and management of perinatal mental health problems for equity. Methods Studies reporting the presence or absence of variation by a social, economic or demographic group were quality appraised and the presence and direction of disparity tabled. We calculated standardised absolute prevalence estimates for overall detection and management, and absolute and relative estimates by determinants grouping. A thematic analysis of the studies that examined potential reasons for disparity was undertaken. Results Six studies, with no major quality concerns, provided consistent evidence of reduced identification and management for ethnic minority women, both those who do, and do not, speak English. There was less consistent evidence of inequality for other axes of social disparity and for characteristics such as age, parity and partnership status. Explanations centred on difficulties that translation and interpretation added to communication, and hesitancy related to uncertainty from healthcare providers over cultural understanding of mental health problems. Conclusion The identification and management of perinatal mental health problems is likely to be inequitable for ethnic minority women. Further systems-based research should focus on clarifying whether other groups of women are at risk for inequalities, understand how mismatches in perception are generated, and design effective strategies for remediation. Inequalities should be considered when reviewing evidence that underpins service planning and policy decision-making.

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“…Although ATAPS sessions are not subsidised by Medicare, referral to this program requires the completion of a mental health plan using an appropriate MBS mental health item by a referring professional, such as a general practitioner or maternal health nurse. Previous research using ALSWH data has shown that self‐reported perinatal depression screening rates increased earlier in NSW than in other states 18 and while we have assumed for the purposes of this study that SAFE START came into complete effect on 1 April 2010, in reality some sites and health districts in NSW were well established prior to this time. This was further demonstrated in the final report of the beyondblue Postnatal Depression Screening Program: of the more than 40,000 women who participated in this landmark initiative between 2002 and 2005, over half (52.8%) were recruited from NSW, reflecting that procedures, policies and service networks had been well‐defined in NSW prior to the introduction of SAFE START 31…”

Section: Discussionmentioning

confidence: 91%

“…Self‐reported depression screening rates among pregnant women and new mothers in Australia has increased significantly since 2000 18 . In NSW specifically, the proportion of women who reported being screened both before and after birth, as is currently recommended, increased from 25% in 2000 to 61% in 2016.…”

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confidence: 99%

Increases in use of Medicare Benefits Schedule mental health items among women who gave birth in New South Wales, 2009–2015

Reilly

Egan

Austin

et al. 2022

Australian and New Zealand Journal of Public Health

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Objective: To report rates of Medicare Benefits Schedule (MBS) mental health item use among a sample of women who gave birth in NSW (2009‐2015) and examine if the SAFE START policy increased use of these items among perinatal women. Methods: Data was drawn from women participating in the Australian Longitudinal Study on Women's Health 1973‐1978 cohort, linked to data from the NSW Perinatal Data Collection and MBS. Results: Use of Medicare‐subsidised mental health items increased 2.7‐fold among perinatal women (n=1,453) between 2009 and 2015 (4.1% versus 11.0% respectively), compared to a 1.3‐fold increase among non‐perinatal women (n=1,800, 6.3% versus 8.4% respectively). However, the increased use of MBS mental health items among perinatal women was not observed to be impacted by the SAFE START policy, after accounting for time trends. Conclusion: There was a substantial increase in the use of MBS mental health items among women in NSW between 2009 and 2015, with a more pronounced increase among women who had given birth compared to those who had not. Implications for public health: This study provides important information about changes in mental health service use during a time of significant investment in perinatal mental health, and demonstrates the value of longitudinal survey data linked with administrative health data to evaluate the impact of health policy.

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How rates of perinatal mental health screening in Australia have changed over time and which women are missing out

Cited by 26 publications

References 30 publications

Perceived social support on postpartum mental health: An instrumental variable analysis

Perceived social support on postpartum mental health: An instrumental variable analysis

Inequalities in the identification and management of common mental disorders in the perinatal period: An equity focused re-analysis of a systematic review

Increases in use of Medicare Benefits Schedule mental health items among women who gave birth in New South Wales, 2009–2015

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