A new project is successfully delivering mental health care to pregnant women in South Africa, researchers reported last night.
The developers of the project, led by Dr Simone Honikman of the University of Cape Town, South Africa, explain that maternal mental health is largely neglected in low- and middle-income countries. This is despite recent figures showing that maternal mental disorders are three times more prevalent in low- and middle-income countries than in high-income countries.
Because there is no routine screening or treatment of maternal mental disorders in primary care settings in South Africa, Dr Honikman set up the Perinatal Mental Health Project. It delivers mental health care to pregnant women "in a collaborative, step-wise manner making use of existing resources in primary care".
Health care workers were trained to carry out routine antenatal screening for maternal mental distress, and networks were set up to refer women to on-site counsellors and mental health professionals.
Over a three-year period, 90 per cent of 6,347 women attending antenatal care were offered mental health screening. Ninety-five per cent agreed to screening, of whom 32 per cent qualified for referral to counselling. Nearly two-thirds (62 per cent) agreed to be referred. After counselling, 88 per cent of women said they felt more able to cope with their current situation. Two per cent were referred on to a psychiatrist.
This model "demonstrates the feasibility and acceptability of a stepped care approach to provision of mental health care at the primary care level", say the experts in the journal PLoS Medicine today (May 30).
They add: "These principles may inform the development of services in similar primary health settings."
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