Frequent screening using multiple instruments (as appropriate) leads to the most opportunities for help!
Screening Tools for Postpartum Depression and Anxiety:
All pregnant and postpartum people and partners should be screened for perinatal mood and anxiety disorders (PMADs). There are several well-established tools that can assess emotional well-being.
Edinburgh Postnatal Depression Scale (EPDS):
Can be used prenatally and postpartum; does have items specific to anxiety; can be used with fathers.
Perinatal Anxiety Screening Scale (PASS):
Does not include assessment for depression; able to assess 4 categories of anxiety that can aid in clinical management and treatment.
Patient Health Questionnaire (PHQ-9):
Already used in most medical settings; does not screen for anxiety; not specific to perinatal period.
The Basics of a Therapeutic Screen:
A successful screen must generate a feeling of trust, compassion, and caring between the parent and the provider. We recommend all providers consider the following key points when screening:
Screening is a chance for you to connect to a parent. Everyone deserves a chance to talk about how they are doing. Providers should follow-up with every parent who completes a screening, regardless of their score.
We know that many parents under-report their symptoms out of fear of judgment. When following up with a parent, consider starting with:
"Even though you are here for your child’s visit, I’d like to take a few moments and hear about how you are doing."
“Many parents find the first year full of unexpected challenges. Your experience matters to us. I’d like to hear how you are doing.”
“Thank you for completing the perinatal mental health screening. I also want to hear in your own words how you feel like you are doing.”
Simple, gentle follow-up questions include:
- What was it like for you to answer the screening questions?
- What questions do you have for me?
- What concerns do you have?
- Is there anything else the screen did not ask that you want me to know?
- How well would you say the results reflect how things are actually going?
Planning & Discussion Tools for Providers
PRENATAL PLANNING TOOLS:
Starting the conversation in pregnancy is the best way to help parents. These tools can be provided to parents to complete on their own or in conjunction with a provider or other support person.
SYMPTOMS CHECKLISTS & DISCUSSION TOOLS:
These can often help parents who are struggling to identify what they are feeling and offer some shared language for parents and providers to use in their conversations together.
Knowing there are actual steps that can be taken to help you feel better can be an incredibly powerful lifeline as a new parent. Written and distributed by Perinatal Support of Washington, these Wellness Plans help parents start to see all the opportunities for support. While best started with a trained professional, these plans can be done independently by a parent or provided along with a referral.