Maternal Distress Screening Tool

The PMHP identified a major obstacle to providing mental health care: the relevant mental health screening tool validated for our setting, the Edinburgh Postnatal Depression Scale (EPDS), does not address the context-specific needs of our health system. The EPDS has proven too cumbersome for routine use in busy antenatal clinics, and it is not sufficiently sensitive to a context challenged by HIV/AIDS, poverty, high rates of violence and trauma and a severe lack of social support within low-income communities.

The high prevalence of maternal depression in South Africa requires that maternal mental health screening, performed routinely and on-site, be logistically feasible and responsive to the local risk factors which may influence mental distress. To address this gap, we have developed a brief 5-question screening tool to identify symptoms of depression, anxiety and suicidal ideation.  

The study was based at our Hanover Park Site Women attending the maternity service were screened, offered counselling if required and referred to social support services where appropriate. Screening included the PMHP’s risk factor assessment, as well as several other risk and mood screens which are being assessed against a diagnostic gold standard. The most robust screening items were identified for inclusion in a valid, responsive and pragmatic new tool which may be used in limited-resource settings.