A 6 week course designed to support women with post natal depression (PND).
This example was originally submitted to demonstrate implemention of NICE guideline CG45. This guideline has now been updated and replaced by CG192. The practice outlined in this example has been reviewed and is consistent with the updated NICE guidance. The updated guidance should be referred to if replicating practice described in this example.
Aims and objectives
To support women suffering from postnatal depression and to equip them with strategies to aid their recovery and to prevent relapse
- Individual Risk assessments
- Mutual Support
- Therapeutic interventions and/or referral to other agencies
Reasons for implementing your project
Towards the end of 2006, a discussion took place between the health visitors and primary care mental health workers in the local clinic about the numbers of women suffering from postnatal depression in the locality. It transpired that Laura Platt (Primary Care Mental Health Worker) and Anna Wardle (Health Visitor) both had a particular interest in the subject.
We had several meetings to discuss service and patient need, current service provision and treatment options available for this particular client group. Through these discussions, we have developed a six-week programme that incorporates interventions that would be offered by both the Health Visiting and Primary Care Mental Health Teams. We ran our first group in February 2007, which coincided with the publication of the NICE guidelines on antenatal and postnatal mental health. There has also been a recent increase in the amount of media coverage on postnatal depression. Previously it was thought that between 10-15% of women experience postnatal depression. However, recent findings from a survey carried out by netmums.com show that up to 52% of women exhibit symptoms of postnatal depression, thus highlighting the increased need to focus service provision on this area. We deliver approximately 6 courses a year and to date have had 60 women attend with an average of 3 - 6 per course.
How did you implement the project
- Most of the women benefited from attending and were equipped with tools to prevent relapse.
- Evaluations have been very positive and the initiative was runner up in the mental health category of the "Nursing in Practice" awards last year.
- Referrals to the group are now increasing and GP's are now also referring.
- A training programme had been designed and delivered to train staff in the detection of PND.
- Several other health visitors have "shadowed" the group with an aim to providing an equitable service across the trust.
- Health visitors are to be given extra training in risk assessment and they have an open access to support supervision from the mental health services.
- Creche facilities have now been set up via the children's centres to offer child care for women who have older children.
On week one, the Clinical Outcomes in Routine Evaluation (CORE) and Depression Anxiety Stress Scales (DASS) are administered, scored and risk assessed. We were both amazed at how open and honest the women were with us, and each other. Some sessions were very intense and the women were offered one to one work if they needed it. We also made sure we put time aside for us both to 'de brief' following the sessions.
On week six, the same measures are administered and scored. A marked improvement in the scores is noted in the majority of the women attending the group. We also asked the women to complete a subjective evaluation form, which looked at various aspects of the course content to help us plan future courses.
Here are some of the comments:
- 'Thanks so much for being there, listening and understanding. You really have made a difference.'
- 'It was so nice to talk freely and listen to other people. It made me realise I was ill not horrible.'
- 'I was not sure about the group before I came, but I have really gained so much from the sessions. I would not be doing half of what I am doing now if I had not come.'
- 'Thanks for giving us space and time to cry.'
To date we have had 60 women completed the course.
Key learning points
A lot of planning is needed to initiate a group like this. We have adapted the course over the period following feedback/evaluations from the women attending. Anyone thinking of setting up something similar needs to make sure they are given protected time and are able to access support/supervision from the mental health services in their area. Ensure you have a room booked which is baby friendly and that there will not be any interruptions Finally.....always have plenty of tissues handy!