Experiences with the routine use of the Edinburgh Postnatal Depression Scale from health visitors' and midwives' perspectives - An exploratory qualitative study.

BACKGROUND: The Edinburgh Postnatal Depression Scale has been practiced as a routine screening for postnatal depression at a municipal health care centre for more than ten years. OBJECTIVES: The aim of this study was to examine how health visitors and midwives perceive and practice this routine screening. STUDY DESIGN: We chose an exploratory qualitative approach, with analysis of data from focus group interviews. METHODS: Ten health visitors and two midwives participated in two focus group interviews by sharing their thoughts and reflections. The analysis was performed in collaboration with all authors according to thematic network analysis. FINDINGS: The Edinburgh Postnatal Depression Scale is well accepted as a screening tool. In addition to giving health visitors and midwives information about mothers who need special attention concerning mental health challenges, the Edinburgh Postnatal Depression Scale is a tool for talking about problems related to early motherhood. A trusting relationship is a prerequisite for these conversations. The health visitors seldom use the word 'depression' in contact with the individual mother. They sometimes lose opportunities to identify mothers in need of help because of a tight time schedule and social and cultural factors. Collaboration on a daily basis with colleagues and family therapists, and monthly guidance from mental health professionals are necessary to secure professional quality and confidence. CONCLUSION: The Edinburgh Postnatal Depression Scale is a useful screening tool, but there are social and cultural challenges, and the available time during screening consultations is often too short. Collaboration with and guidance from other professionals are necessary.

"It's about focusing on the mother's mental health'': screening for postnatal depression seen from the health visitors' perspective--a qualitative study.

AIMS: This study examines experiences from the implementation of EPDS as a routine screening for postnatal depression in a health centre seen from health visitors' perspective. METHODS: A qualitative approach was chosen to shed light on this issue. Six experienced health visitors and one midwife participated in a focus group interview sharing their experiences and expectations. RESULTS: The analysis indicate that the EPDS screening turned out to be a useful tool for the health visitors to adress mental health issues in health promotion and preventive work with mothers and newborns. The EPDS screening shifted the focus in the consultation from the child solely to also encompass the mother and the relation between them. A precondition for this was that the implementation process was gradual and on the health visitors own terms, likewise that there was a follow-up chain including supervision given to the health visitors, in order to provide help for the mothers who need more help than the health centre can offer. CONCLUSIONS: Our study shows that acceptability for routine screening with EPDS amongst health visitors is possible to achieve.