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Willey SM, Gibson ME, Blackmore R, Goonetilleke L, McBride J, Highet N, Ball N, Gray KM, Melvin G, Boyd LM, East CE, Boyle JA. Perinatal mental health screening for women of refugee background: Addressing a major gap in pregnancy care. Birth 2024; 51:229-241. [PMID: 37859580 DOI: 10.1111/birt.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/24/2023] [Accepted: 09/21/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Perinatal mental health disorders affect up to 20% of all women. Women of refugee background are likely to be at increased risk, yet little research has explored this. This study aimed to assess if women of refugee background are more likely to screen risk positive for depression and anxiety than non-refugee women, using the Edinburgh Postnatal Depression Scale (EPDS); and if screening in pregnancy using the EPDS enables better detection of depression and anxiety symptoms in women of refugee background than routine care. METHODS This implementation study was conducted at an antenatal clinic in Melbourne, Australia. Women of refugee and non-refugee backgrounds were screened for depression using English or translated versions of the EPDS and a psychosocial assessment on a digital platform. The psychosocial assessment records of 34 women of refugee background receiving routine care (no screening) were audited. RESULTS Overall, 274 women completed the EPDS; 43% of refugee background. A similar proportion of women of refugee and non-refugee backgrounds had EPDS scores of ≥9 (39% vs. 40% p = 0.93). Women receiving the combined EPDS and psychosocial screening were more likely to receive a referral for further support than women receiving routine care (41% vs. 18%, p = 0.012). CONCLUSION Similarly, high proportions of women of refugee and non-refugee backgrounds were at increased risk of experiencing a current depressive disorder in early pregnancy, suggesting pregnancy care systems should acknowledge and respond to the mental health needs of these women. Screening appeared to facilitate the identification and referral of women compared to routine care.
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Affiliation(s)
- Suzanne M Willey
- School of Nursing and Midwifery, Peninsula Campus, Monash University, Victoria, Clayton, Australia
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Clayton, Australia
| | - Melanie E Gibson
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Clayton, Australia
- Te Tātai Hauora o Hine - National Centre for Women's Health Research Aotearoa, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Rebecca Blackmore
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Clayton, Australia
- Centre for Mental Health, Swinburne University of Technology, Victoria, Hawthorn, Australia
| | | | - Jacqueline McBride
- Monash Refugee Health and Wellbeing, Monash Health, Victoria, Melbourne, Australia
| | - Nicole Highet
- Centre of Perinatal Excellence, Victoria, Flemington, Australia
| | - Natahl Ball
- Monash Health, Maternity Services, Victoria, Clayton, Australia
| | - Kylie M Gray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Victoria, Clayton, Australia
| | - Glenn Melvin
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Victoria, Burwood, Australia
| | | | - Christine E East
- School of Nursing and Midwifery/Judith Lumley Centre & Mercy Health, La Trobe University, Victoria, Bundoora, Australia
| | - Jacqueline A Boyle
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Victoria, Clayton, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
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