Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia.
OBJECTIVE
This study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia.


METHODS
Audits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral.


RESULTS
Around 18% (n=141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women's life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n=86), counselling of 57% (n=80) and cognitive behaviour therapy of 5% (n=7). About 39% (n=55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women's refuge centre.


CONCLUSIONS
The higher risk of APD associated with women's life style behaviour indicates that the better understanding of mental health in its cultural context is essential.
Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia. Electronic address: Kaniz.gausia@uwa.edu.au.
Kaniz
K
Gausia
Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald Street, Geraldton, WA 6530, Australia. Electronic address: Sandra.thompson@uwa.edu.au.
Sandra C
SC
Thompson
Mental Health, Wellbeing and Chronic Diseases Division, Menzies School of Health Research, Casuarina, NT 0811, Australia. Electronic address: Tricia.Nagel@menzies.edu.au.
Tricia
T
Nagel
Menzies School of Health Research, Casuarina, NT 0811, Australia. Electronic address: gill.schierhout@menzies.edu.au.
Gill
G
Schierhout
ABCD National Research Partnership Project, Menzies School of Health Research, Level 1, 147 Wharf Street, Spring Hill, QLD 4000, Australia. Electronic address: Veronica.Matthews@menzies.edu.au.
Veronica
V
Matthews
ABCD National Research Partnership Project, Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Casuarina, NT 0810, Australia. Electronic address: Ross.Bailie@menzies.edu.au.
Ross
R
Bailie
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology; D000554:Ambulatory Care Facilities; D000928:Antidepressive Agents / Q000627:therapeutic use; D001315:Australia; D054869:Clinical Audit; D015928:Cognitive Behavioral Therapy; D003376:Counseling; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000628:therapy; D011320:Primary Health Care; D011570:Psychiatry; D011584:Psychology; D011614:Psychotherapy, Brief; D058996:Quality Improvement; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012947:Social Work; D013315:Stress, Psychological / Q000453:epidemiology* / Q000628:therapy; D019966:Substance-Related Disorders / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult
D000928:Antidepressive Agents
Antenatal Psychosocial Distress; Australia; Depression; Indigenous women; Social and emotional wellbeing (SEWB)