Routine assessment of current or past mental health issues during pregnancy and the postnatal period has been endorsed in clinical practice guidelines in Australia and a number of other countries. However, there is little evidence as to whether such assessments increase rates of referral for further treatment or management.

The aim of this study was to evaluate the impact of current and past mental health on referral for additional support or treatment during pregnancy and the first postpartum year. A subsample of 1,804 women from the 1973-78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH) provided data.

  • The strongest predictor of being given a referral for additional treatment or support during pregnancy was being asked by a health professional about past mental health.
  • Women who were asked about current mental health were also more than twice as likely to receive a referral.
  • The odds of receiving a referral were around 14 times higher for women who were asked about both their current and past mental health than for women who did not receive any form of assessment.
  • Being asked about one’s past or current mental health during the postnatal period also increased the likelihood of referral during the postnatal period.
  • The odds of receiving a referral were around 16 times higher for women who were asked about both their current and past mental health compared with women who received no assessment.
  • Experiencing significant emotional distress also predicted referral during both the prenatal and postnatal periods, suggesting that assessment did not inappropriately inflate referral rates.

The findings indicate that enquiry into risk factors such as past history (in addition to current mental health) enhances initiation of referrals, and highlights the importance of a comprehensive approach to mental health assessment.

Citation: Reilly N, Harris S, Loxton D, Chojenta C, Milgrom J, Austin M-P (2013). Referral for management of emotional health issues during the perinatal period: Does mental health assessment make a difference? Birth, 40(4), 297-306.

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