Lost in Translation: Staff and Interpreters’ Experiences of the Edinburgh Postnatal Depression Scale with Women from Refugee Backgrounds

Abstract

This paper explores the cross-cultural application of the Edinburgh Postnatal Depression Scale (EPDS) and the difficulties associated with administration to women from refugee backgrounds. Assessing women's comprehension of individual scale items identified problems associated with "Western" terminology and concepts. Re-interpretation of discrete items on the scale was often necessary, raising doubts about the objectivity and reliability of scores. Our findings call for a closer examination of the ethnocentric assumptions underpinning the EPDS items, and the need to incorporate a more diverse range of cross-cultural understandings into future iterations.

Factors affecting implementation of perinatal mental health screening in women of refugee background

“…Achieving cultural equivalence in EPDS translations and having accurate, female interpreters is consistent with the literature [21, 24, 40, 41]. Results from this study add that female interpreters are a priority specifically for mental health conversations to encourage disclosure from women with traumatic backgrounds.…”

“…Some HP concerns regarding EPDS administration in this population are consistent with other research [24]. However, the positive perceptions of the EPDS by CRs and interpreters and their understanding of the impacts of perinatal mental illness contrast with a recent study, which described women’s lack of understanding of EPDS items and concepts, and postulated that women of refugee background lacked a framework for understanding the rationale behind EPDS administration [24]. …”

“…Previous studies of maternity care models with women of refugee background have not explored mental health screening [21, 22], system challenges or factors critical to success in rolling out a comprehensive screening and referral programme [24, 25]. …”

Detecting antepartum and postpartum depression and anxiety symptoms and disorders in immigrant women: A scoping review of the literature

“…Health‐care professionals were found to rely on interpreters when using tools to assess for PPD symptoms in non‐English speaking mothers (Stapleton et al . ). Stapleton et al .…”

“…Mothers also had concerns if the interpreters were from their community, as they were worried that information might not be kept confidential (Stapleton et al . ). With these concerns, mothers might be less likely to reveal mental health issues.…”