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Women Birth. 2019 Jun 7. pii: S1871-5192(19)30155-6. doi: 10.1016/j.wombi.2019.05.007. [Epub ahead of print]

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

Author information

1
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia. Electronic address: suzanne.willey@monash.edu.
2
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia.
3
Department of Nursing, Midwifery & Health, Faculty of Health & Life Sciences, Northumbria University, Coach Lane Campus West, Newcastle upon Tyne NE7 7XA, United Kingdom.
4
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; Monash Nursing and Midwifery, Monash University, Wellington Rd, Clayton, Victoria, 3168, Australia; Honorary, Monash Health, 246 Clayton Rd, Clayton, Victoria, 3168, Australia.
5
Cabrini Institute, 154 Wattletree Rd, Malvern, Victoria 3144, Australia.
6
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia; Department of Obstetrics & Gynaecology, Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia.

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

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