In the developing world the prevalence of maternal mental disorders is significantly high and until recently there was no routine screening or treatment of maternal mental disorders in primary care settings in South Africa. Now, South African researchers reveal that a new approach to screen pregnant women for these disorders shows promise. The study is published in PLoS Medicine.

Simone Honikman and her team from the University of Cape Town, implemented a program (The Perinatal Mental Health Project) in Cape Town, South Africa. The program was designed to:

  • Train health care workers
  • Implement routine antenatal screening for maternal mental distress
  • Establish referral networks to counsellors and mental health professionals

According to the researchers: “The Perinatal Mental Health Project developed an intervention to deliver mental health care to pregnant women in a collaborative, step-wise manner making use of existing resources in primary care.”

Between 2008 and 2011, the researchers found that the program achieved high levels of uptake and acceptability. Of the 6,347 women who attended the facility for primary level care, 90% were offered mental health screening and of the 5,407 women screened, 32% qualified for referral to a counsellor, with 1,079 women (62%) of those who qualified agreed to be referred.

Of the 1,981 counseling sessions that took place, only 20 women (2%) were referred to see a psychiatrist. Furthermore, the team found that the majority of women (88%) reported that counseling helped them to cope with their presenting problem.

The researchers said:

“Through routine screening and referral, the [Perinatal Mental Health Project] model demonstrates the feasibility and acceptability of a stepped care approach to provision of mental health care at the primary care level.

These principles may inform the development of services in similar primary health settings.”

Written By Grace Rattue