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Discussion of EPND results

Post-Natal Depression Results

 

A retrospective survey of scores over the past eighteen months has identified the following results:

Of the 218 women screened for post-natal depression, 83 (38%) had elevated scores, (ie 9 and above) at either the first or the second screening.

37 (17%) women scored between 9 and 12 ie borderline scores.

46 (21%) women scored above 12, indicative of being in a depressed state of mind.

Of the 83 women identified 67 (81%) received Health Visitor intervention.

Further analysis of the data identifies what support and treatment was provided by the Primary Health Care Team as a whole.

Group 1

1st score normal, 2nd raised.

Total: 15

15 women scored below 9 on first screening, but then scored higher on their second screening. 11 scored between 9-12 and 4 scored above 12 on their second screening. This highlights the necessity for repeating the screening between 12-16 weeks following the birth.

All the women were offered support visits, however 6 declined (2 of these women were already taking anti-depressant medication.) Explanations ranged from work commitments to already having a supportive family network.

1 woman moved out of the area.

Of the remaining 8 women:

4 received support visits only.

3 received support visits and were also prescribed anti-depressant therapy.

1 woman received support visits, anti-depressants and was also referred to the surgery counselling service.

Group 2

1st scored raised, 2nd score normal

Total: 22

12 women had initial borderline scores ie, between 9-12 followed by a second score of below 9

10 women scored above 13 on first screening and below 9 on second screening.

Of the women with initial borderline scores, 5 declined support visits and 1 woman moved away. Of the remaining 6 women:

3 received support visits only.

3 required support visits and anti-depressant therapy.

Of the 10 women who scored above 13 initially, only 1 declined support visits:

5 received support visits only.
1 received support visits and anti-depressant therapy.
1 received both of the above and was also referred to a counsellor.
2 women, as well as receiving support visits and anti-depressants were also referred to the 'Take Control' exercise scheme.

Group 3

Both scores raised, 2nd higher.

Total: 16

13 women recorded initial borderline scores with the second score being above 12.

3 women recorded scores above 12 on first and second screening.

3 received support visits only.
7 were also prescribed anti-depressant medication.
As well as the above, 2 women were also referred to the 'Take Control' scheme.
1 woman received support visits, referral to 'Take Control' and was also referred to a Social Worker.
2 women received support visits, anti-depressants and referral to a Counsellor.
1 woman received support visits, anti-depressants and referral to the Community Psychiatric Nursing service.

Group 4

Both scores raised, 2nd lower.

Total: 17

13 women scored above 12 on first screening, of which 9 had borderline scores on second screening while the remaining 4 still recorded scores above 12.

4 women recorded borderline scores on both occasions with the second score being marginally lower. All 17 women received support visits.

8 required support visits only.
4 were prescribed anti-depressant therapy as well as support visits.
3 women received support visits, anti-depressants and were also referred to a Counsellor.
1 woman received support visits, anti-depressants and was referred to the Community Mental Health Team.
1 woman received support visits only and referral to the Community Mental Health Team.

Group 5

1st score raised, no second score available

Total: 13

6 women recorded borderline scores and 7 recorded scores above 12 on first screening. No second scores were recorded. Reasons for this are varied: 4 women moved away, 1 woman suffered a bereavement where it was deemed inappropriate to record a second score. One baby sustained a non-accidental injury and was removed from the care of the mother, where it was again deemed inappropriate to record a second score. Of the remaining 7, access was not made available, either because the woman was working or did not keep the pre-arranged appointment specified. Of the 13 women, 11 received support visits.

3 received support visits only.
5 received support visits and anti-depressant therapy.
1 woman received support visits, anti-depressants and was also referred to a counsellor.
1 woman received support visits only and was referred to a counsellor.
1 woman received support visits, anti-depressants, referral to a Counsellor as well as referral to the Community Psychiatric Nursing Service.

Summary

Of the 83 women identified with borderline or actual depression, 67 (81%) received between 1 and 6 support visits.
46 (21%) women scored above 12, ie indicative of being in a depressed state. The national average is 10-15%
37 (17%)women recorded borderline depression scores.
26 (39%) women received support visits only.
35 (52%) women were prescribed anti-depressant therapy.
11 (16%) women were referred to a Counsellor.
5 (7%) women were referred to the 'Take Control' exercise scheme.
4 (6%) women were referred to the Community Mental Health Team.
12 (18%) women declined support visits.
12 (18%) women scored positively to question 10, ie self-harm. Immediate liaison with the GP occurred in each case.

Post-Natal Depression Policy

Discussion of Results