Early detection and treatment of perinatal mental health disorders: A perinatal mental health care protocol

Aim: Perinatal mental health problems are highly prevalent and are associated with a range of adverse consequences for the mother and her offspring. Mental health screening during pregnancy offers a major opportunity for early detection and treatment for perinatal mental health problems. The objective is to describe a Perinatal Mental Health Care protocol based on expert consensus and research evidence where available. Methods: The risk assessment is followed by a stepped screening protocol at 20 weeks of pregnancy. The screening protocol involves the Whooley questions for depression and the GAD-2 (yes/no) for anxiety, followed by the Edinburgh (postnatal) Depression Scale, E (P)DS and the GAD-7 when one of the two Whooley questions or both GAD-2 questions are positive. A positive screening on the E(P)DS or the GAD-7 (a score of 13 or more or a score of 15 or more respectively) leads to a prompt referral to the psychologist or psychiatrist at the maternity services for further clinical assessment and treatment when necessary. The general practitioner of the pregnant wife is further informed by letter. Six weeks after the delivery, the stepped screening protocol is repeated. Results: Preliminary results of the development and the implementation of the Perinatal Mental Health Care protocol will be discussed. Conclusion: Screening and assessment and treatment integrated in routine perinatal care at the maternity services may enhance mental health of women during perinatal period.