DEVELOPING INNOVATIVE PROGRAMS

THE CHILDBIRTH STRESS AND DEPRESSION PROJECT: DEVELOPING STATEWIDE SERVICES

Sherryl Pope, J Watts, P Stephenson, P Boyle
Clinical Psychology Dept, King Edward Memorial Hospital, Subiaco, WA

The Centre for Women's health (incorporating KEMH) was allocated National Mental Health Project funding for 3 years, 1995-1997, to develop and implement statewide strategies in the area of Childbirth-related Mental Health. KEMH is the only tertiary hospital and largest single service provider in Western Australia of specialist obstetric, gynaecology and neonatal paediatric services (5,000 deliveries per annum).

The Clinical Psychology Dept at KEMH was responsible for the consultation, planning and implementation of appropriate strategies for Childbirth Mental Health, and linking regional areas with a central focus as the Centre for Women's Health. Statewide consultation sessions were held with health professionals and health consumers in 1995 to assess the range of existing services, identify gaps in services and recommend improvements in the assessment and management of Childbirth Mental Health problems. The "Report on Childbirth Stress & Depression" (Pope, 1995) recommended strategies for service delivery improvement in Western Australia throughout 1996-1997 which were endorsed by the Minister for Health, WA.

This paper outlines the current progress of the Childbirth Stress & Depression Project, and discusses recommendation implemented by the Project Team including:

• conducting extensive workshop training programs for health professionals and Community information sessions in metropolitan and country locations
• negotiating with tertiary institutions to include childbirth-related mental health issues in undergraduate medicine, nursing curricula and allied health postgraduate courses
• convening a Central Reference group to propose Best Practice guidelines for assessment, treatment and service evaluation
• linking with regional areas for the dissemination of information and improvement in inter-agency and inter-disciplinary communication
• offering a professional consultation service for clinical and management issues
• Circulating a quarterly health professional newsletter to provide a regular update of project initiatives
• Forming a self-help network (Postnatal Depression Support Association) and training committee members to provide appropriate telephone and group support and information
• printing specialised information packages suitable for expectant and/or recent parents and distributed to all childbearing women throughout WA in 1997.

CHILDBIRTH-RELATED MENTAL HEALTH: A HEALTH PROFESSIONAL TRAINING PROGRAM

Julie Watts, S Pope, P Stephenson, S Evans
Clinical Psychology Dept, King Edward Memorial Hospital, Subiaco, WA

One of the main recommendations of the Childbirth Stress & Depression Project (WA) was to develop and conduct training programs for health professionals in WA. Training was designed to increase health professionals' knowledge and skills in working with childbirth-related mental health problems. The objectives of the 2 days program were to improve understanding of the range of mental health problems that can occur antenatally and postnatally, increase ability to assess problems both antenatally and postnatally, and improve interviewing and counselling skills. Thus, the overall purpose of the training was to improve service provision in WA.

Health professional training workshops were conducted in 14 locations in WA during 1996: 7 metropolitan and 7 rural. A total of 371 professionals attended workshops in 1996, with the majority of participants being child or community health nurses or midwives. Other professionals included allied health, clinical psychologists, psychiatrists, medical officers and childcare workers. Health professionals attending training workshops completed a pre- and post-workshop questionnaire to assess their knowledge in the area of childbirth-related mental health. Participants also complete a questionnaire evaluating their satisfaction with the workshop, the impact of the training on their understanding and perceived confidence, and how they will apply the skills gained from the training.

In 1997 an additional 19 health professional workshops are planned (9 metropolitan and 10 rural). Workshops will also be conducted for students in the university programs of social work, nursing, occupational therapy and psychology. A followup questionnaire will also be distributed to all workshop participants 3-6 months after they attend the workshop to assess the impact of the workshop in changing their clinical practice.

GENERAL PRACTICE BASED INTEGRATED CARE AND SUPPORT FOR WOMEN AND FAMILIES WITH POSTNATAL DEPRESSION

Alison Creagh, G McKenzie, E Craig
Perth Postnatal Support Project, WA

The Perth Postnatal Support Project enables General Practitioners to further develop care for women and families with antenatal and/or postnatal stress and depression. The project team - a counsellor and a Child Health Nurse - offered direct support, counselling and the opportunity to attend a therapeutic group to women and their partners. It encouraged the utilisation of other appropriate available resources. The project successfully integrated this care with that of the General Practitioners. Education sessions were offered to participating doctors (n=167) and other involved health professionals.

Main Objectives:

1. to provide coordinated general practice based support for women experiencing postnatal problems such as PND, role adjustment, isolation and stress related to the difficulties of early parenting. The target group consisted of those women identified by their GP, child health nurse, clinical psychologist, other agency or the women themselves as having problems, or at risk of having problems, postnatally.

2. to broaden the skills of General Practitioners in the identification and care of those experiencing, or at risk of, PND. The target group was General Practitioners from the Perth Division of General Practice.

3. to facilitate liaison with and the appropriate utilisation of government and non-government agencies working in the related field.