Improving mental health screening in pregnant Aboriginal women

New research by The University of Western Australia has found a way to improve screening for Aboriginal and Torres Strait Islander pregnant women and mothers of young children to better address mental health issues.

The study, published in Social Psychiatry and Psychiatric Epidemiology, provides a foundation for the delivery of local mental health care for perinatal women, covering the period during pregnancy through to the first year after birth.

Researchers at The University of Western Australia and Kimberley Aboriginal Medical Services analysed 91 mental health assessments of women from the Kimberley region to identify different risk and protective factors associated with perinatal depression and anxiety.

Traditional perinatal depression screening typically does not ask women about her protective behaviours and strengths but instead focuses exclusively on her risks.

Previous work with Aboriginal women in the Kimberley region had advised it was important for clinics to ask about protective factors as well as the risk factors when speaking to pregnant women and new mums about their feelings and mood. 

Asking about protective factors helped women feel ‘strong’ to yarn and helped take away some of the stigma associated with talking about mood and feelings. 

The researchers found almost all of the women had protective factors and that contributed to them not experiencing anxiety or depression despite having many experiencing significant risk factors. 

The most prominent protective factor was positive relationships with family members.

Lead author Emma Carlin, from UWA’s Rural Clinical School of Western Australia and the Kimberley Aboriginal Medical Services, said assessing Aboriginal women’s perinatal mental health by only looking at risk was not enough. 

“It is important the health professional explores a woman’s whole context, including the way a woman experiences stress and risk and how her protective factors support her,” Ms Carlin said.

Associate Professor Julia Marley, also from UWA’s Rural Clinical School of Western Australia and the Kimberley Aboriginal Medical Service, said for Aboriginal women were an under-screened population and it was critical to have screening tools that were acceptable and culturally safe.

“Here in the Kimberley, we have developed the Kimberley Mum’s Mood Scale alongside Aboriginal women which has been validated in Kimberley clinical settings,” Associate Professor Julia Marley said.

“It is through that co-design process that we have the first perinatal screening tool in Australia that explores protective factors alongside risk and helps us understand the significance of protective factors on diagnostic outcomes. 

“When women engage in acceptable screening practices, health services are able to identify and support women to optimise their perinatal health during this period. 

“Good mental health is a good health outcome for mum, baby and the whole family.”