Simple test could change mothers’ lives
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Cape Town - A short and accurate mental health screening tool has been validated for pregnant and post-natal women in South Africa.
The tool, which is made up of just three short questions and was developed by the Perinatal Mental Health Project (PMHP) at UCT, has shown success in picking up depression and anxiety during or after pregnancy.
PMHP’s founding director, Simone Honikman, said: “We realised that in the real-world setting, the screening has to be brief and easy to use, especially if we want to integrate it as a routine part of a health assessment.”
She said that in a busy rural maternity clinic, for example, where there was a heavy patient load and there were only a few staff members, “there has to be a tool that is absolutely straightforward but is also sensitive and specific for what we are wanting to pick up. We don’t want to over-detect cases or miss cases”.
Honikman and the team realised that the screening could not consist of too many questions, and that it could not be multiple-choice because of the time it took to calculate scores. Instead, they defined a short and simple three-part “yes/no” questionnaire similar to one used in the UK and which will form a routine part of a check-up.
Two questions look for symptoms of depression and anxiety, and the third determines whether the patient would like to seek help.
In cases in which patients said yes to the first two questions and then no to an offer of help, health-care personnel were trained to “actively suggest it”, said Honikman.
Research has found that in South Africa nearly 40 percent of women living in poverty experience a mental illness during pregnancy and that the prevalence of maternal mental illness is higher here than in other developing countries.
Samantha, who asked to remain anonymous, suffered from depression during her pregnancy. She said support should not be viewed as a luxury.
“Although my pregnancy was planned, and eagerly awaited, I noticed that I was not as excited and happy as I had previously anticipated. Not knowing what to expect, however, I kept these feelings to myself,” she said.
But, because of a routine mental health screening during one of her check-ups, it became clear she was depressed.
“Psychosocial support can often be seen as a ‘nice-to-have’, add-on service.
“Through my traumatic experience, however, I was able to see how necessary psycho-social support is, and what a huge impact it can have on the quality of care provided to health-care users.”
Janey Ball, a spokeswoman for Circles of Support, which is an event at the Baxter Theatre on August 16 to raise awareness and funds for a screening project in Hanover Park, said: “This is a community of high risk and need.
“Fifty-five percent of people of working age are unemployed and 42 percent of households have a monthly income of R3 200 or less.”