Perinatal Mental Health

2 Perinatal Mental Health Programs

‘Baby Coming – You Ready’

The ‘Baby Coming – You Ready?’ (BCYR) is a culturally validated, culturally secure and strength-based mental health screening tool which does much more than screen for perinatal depression. It was developed through the ‘Kalyakool Moort’ research project to support the social and emotional wellbeing of Aboriginal and Torres Strait Islander mothers and fathers before and after baby comes. The rubric is a process of assessment shared between client and clinician to help understand complex situations. The process encourages self-evaluation and reflection and fosters understanding for both users. It is designed to be used with women and their families during pregnancy and the first 1000 days of their babies life, it aims to give control back to the mother-to-be throughout her perinatal journey; create trust and engagement; screen for strengths to be built upon; identify accumulative stressors and the degree of resultant distress; provide a personalised framework for shared development of a strength-based, family-centered management plan; identify a strong Aboriginal family/community member to act as ‘champion’ for the mother/father-to-be throughout her pregnancy and journey into parenthood.

It utilises specific evidence-based procedures: Brief Intervention, SMART goal setting and Motivational Interviewing techniques to ensure culturally safe, timely, family-centered follow-up and increase a sense of ownership, personal-control and empowerment for parents. The tool uses visual images on a touch screen device that portray emotions, circumstances and events, both positive and challenging, that a mother (or father-to-be) may have experienced or be experiencing. These images guide both the clinician and the parent-to-be through specific domains of inquiry in a relaxed and engaging manner. As images are selected, they automatically populate the basic framework for an emerging personalised management plan that identifies problems and builds on existing strengths. These problems are addressed using SMART goals and are followup during the pregnancy. Once the management plan is completed the health professional receive an automatically interpreted summary into her clinical file, and the parent receives the personalised, password protected plan on their mobile device.

The ‘Baby Coming-You Ready?’ rubric does not use scoring to quantify risk rather it creates a framework whereby the parent-to-be and the midwife jointly identify how soon the follow-up occurs  ie. immediate (an imminent safety risk), short term  (1-5 days), medium term (6-14 days), longer term (2-3 weeks) or routine (4 weeks) or and whether a direct personalized or ‘warm’ referral process is required.

References

Kotz, J., & Robinson, M. (2018).‘Baby Coming – You Ready?’ An audacious innovation to perinatal social and emotional wellbeing assessment screening and supportive management for vulnerable parents-to-be. Women and Birth, Volume 31, Supplement 1, (Page S3)

Kimberley Mum’s Mood Scale (KMMS)

The KMMS is a 10-item screening tool for postnatal depression and anxiety adapted from the Edinburgh Postnatal Depression Scale. It was originally validated for women in the Kimberley region in Western Australia but has also been adapted for Northern Queensland language groups (Mt Isa and Townsville). The KMMS also includes a psychosocial discussion which provides opportunity for new mothers to talk about issues of interest and concern to them.

Further Reading

Kotz, J., Munns, A., Marriott, R., Marley, JV. (2016). Perinatal depression and screening among Aboriginal Australians in the KimberleyContemporary Nurse, 52(1),42–58.

Marley, J. V., Kotz, J., Engelke, C., Williams, M., Stephen, D., Coutinho, S., & Trust, S. K. (2017). Validity and acceptability of Kimberley mum’s mood scale to screen for perinatal anxiety and depression in remote aboriginal health care settings.