Screening for postnatal depression in Swedish child health care

Abstract

To investigate how postnatal depressive mood was identified by child health nurses and which factors were associated with the implementation of screening for postnatal depression and with offering supportive listening visits. A random sample of all 2580 nurses in child health services in Sweden, 499 nurses, were asked to complete a postal questionnaire. A response rate of 70% was achieved. Half of the nurses in the study used the Edinburgh Postnatal Depression Scale (EPDS) and at least another 7% were going to begin. Having the appropriate training, access to regular supervision and pathways to care were essential, and increased the likelihood of using the EPDS. The odds of using the EPDS were six times greater for nurses with access to supervision as compared with nurses without supervision. Most of the nurses who used the EPDS included a follow-up interview on the same occasion as the mother completed the scale, and four out of five nurses allowed extra time for the EPDS. More than half of these allowed half an hour or more. The significance of factors associated with the implementation of routine screening is discussed. Training, supervision and pathways to care were essential for the implementation of routine screening with the EPDS.