Psychosocial assessment and mental health: Use of the Post Natal Risk Questionnaire (PNRQ) in an early parenting facility

Abstract

This study evaluates the clinical usefulness of a psychosocial risk assessment tool (PNRQ) and examines risk factors and acceptability of the PNRQ and mental health of women attending a parenting facility. Women with unsettled infants attending a parenting facility were administered the PNRQ, the Edinburgh Postnatal Depression Scale, the Mini International Neuropsychiatric Interview and a sociodemographic survey. Results from 232 women show that 5.6%met diagnostic criteria for a current depressive disorder and 22.8% for a current anxiety disorder. A total of 53% of women endorsed three or more and 35.8% endorsed four or more ‘significant’ PNRQ risk factors. The likelihood of meeting diagnostic criteria for a current mental illness was significantly increased for women who experienced emotional abuse during childhood (adj. OR 3.386; p=0.006), had high trait anxiety (adj. OR=2.63, p=0.003), or had a negative birth experience (adj. OR 2.78; p=0.015). The results showed high rates of current anxiety disorders and multiple significant psychosocial risk factors among women with unsettled infants. The PNRQ can assist midwives in the identification of specific psychosocial risk factors in women of unsettled infants and address issues beyond infant settling difficulties such as mother–infant interaction and unresolved parenting or trauma issues. Postnatal mental illness can have a profound impact on women, their babies and families. Mental health disorders are one of the three leading causes of maternal mortality in Australia. Early detection of risk factors is crucial to provide vulnerable women optimal support and prevent the negative sequelae of mental illness in the postnatal period.