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Patterns of use of a maternal mental health service in a low‐resource antenatal setting in S outh A frica
Author(s) -
Baron Emily,
Field Sally,
Kafaar Zuhayr,
Honikman Simone
Publication year - 2015
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/hsc.12167
Subject(s) - mental health , resource (disambiguation) , mental health service , service (business) , medicine , psychology , environmental health , nursing , psychiatry , geography , business , computer science , computer network , marketing
The prevalence of perinatal common mental disorders in S outh A frica is high, yet little is known about mental health service use among pregnant and postnatal women. This paper reports on pregnant women's patterns of use of a counselling service at a primary level obstetric facility in C ape T own, S outh A frica, between January 2010 and December 2011. It investigates whether these are associated with demographics, severity and risk of depressive symptoms. Participants ( N = 3311) were screened for psychological distress using the Edinburgh Postnatal Depression Scale ( EPDS ) at their first antenatal visit. Risk factors for antenatal depression were assessed using a 11‐item checklist. Questionnaires were self‐administered, but some participants required assistance. Participants scoring positive (≥13) on the EPDS were offered referral to on‐site, individual counselling, and assigned to one of three groups according to their service use: declined referral; accepted referral and attended counselling sessions; and accepted referral but defaulted all appointments. Consent to participate was received by 3437 (96.4%) participants who were offered screening, of which 627 (18.9%) screened positive on the EPDS . Of these, 363 (57.9%) attended counselling. Both bivariate analyses and regression analyses revealed that age and risk factor assessment score were associated with screening positive on the EPDS . Odds ratios ( OR ) for accepting counselling were OR = 0.94 (95% CI = 0.92–0.97) for gestation, OR = 1.27 (95% CI = 1.15–1.39) for EPDS score and OR = 0.48 (95% CI = 0.23–0.99) for reporting three or more risk factors. OR for attending counselling were, for age: OR = 1.06 (95% CI = 1.00–1.12) and for reporting three or more risk factors: OR = 0.60 (95% CI = 0.37–0.97). While the majority of women with psychological distress accessed the counselling service provided, strategies to increase service use of younger pregnant women specifically are required.