Maternal mental health

Aboriginal children make up a quarter of Saskatchewan’s child population, but they account for 80 per cent of the children within the child welfare system.

This is one of the key findings from a new report called Kiskisik Awasisak: Remember the Children, Understanding the Overrepresentation of First Nations Children in the Child Welfare System.

The report on Aboriginal children is part of the overall Canadian Incidence Study of Reported Child Abuse 2008. It was put together from data in 2008 by a team from universities across the country and follows up similar reports using data from 2003 and 1998.

This month, in Saskatoon, one of the research team members, Dr. Vandna Sinha, assistant professor from McGill University’s Centre for Research for Children and Families, outlined the report’s findings concerning the characteristics of children and caregivers, of households, of cases and forms of maltreatment.

“Neglect is the primary category of maltreatment in 46 per cent of investigations,” Sinha said.

Maternal Mental Health is hosting a lunch hour presentation this month.

Dr. Shaila Misri MD, FRCPC, will be speaking to medical professionals about “Medical Management of Maternal Mental Health Problems” on Sept. 15 from noon to 1 p.m.

The kidSKAN site has some additional information about Maternal Mental Health, including fact sheets and reports. The Maternal Mental Health website has detailed information about this project.

A new video message about the dangers of drinking during pregnancy has a simple message for its intended audience: Thank you, Mom.

The short public service announcement can be seen on YouTube.

As many as one in five mothers in Saskatchewan suffers from depression during or after pregnancy, a study led by University of Saskatchewan researchers Angela Bowen and Nazeem Muhajarine showed. The Feelings in Pregnancy and Motherhood Study recruited 649 women recruited from doctors offices and advertising, interviewing them three times: in early pregnancy, late pregnancy, and after the birth of their babies.

“We have long been aware of postpartum depression, but we wanted to learn more about depression during pregnancy because there can be potential implications to the baby's health, the mother's health and the pregnancy outcomes,” Bowen recently told a reporter from the Saskatoon Sun (see the article here).

"As women in the study were being referred for treatment, a Maternal Mental Health program was initiated. Today the program is run out of West Winds Primary Health Centre and the department of psychiatry in Saskatoon, which can be reached by calling 966-8223 or the Postpartum Hotline at 221-6806.”

As the study, funded by the Canadian Institutes of Health Research, was wrapping up, the researchers launched a provincial Maternal Mental Health awareness campaign to promote universal screening for depression in pregnancy (see their website at [www.skmaternalmentalhealth.ca ], and the fact sheet they developed.

They also established MotherFirst, a policy working group that released a report last fall. The full report contains a provincial strategy for maternal mental health. In March 2011, MotherFirst was a finalist for the Saskatchewan Healthcare Excellence Awards, which recognized innovative work in front-line health and social care.

The large working group is comprised of people from nursing, medicine, mental health, First Nations and others, with Angela Bowen from the University of Saskatchewan’s College of Nursing spearheading the effort. Work began with the Unmasking Postpartum Depression conference in Regina in October 2009, which attracted health practitioners and women from diverse backgrounds.

The MotherFirst report notes how untreated depression and anxiety can lead to enormous personal, social and economic costs, not only for mothers, their entire families and society as a whole.

Some facts of note:

• Up to 20 per cent of mothers in Saskatchewan may face serious depression or anxiety related to pregnancy and childbirth. This has the potential to affect 2,800 families annually.
• The number rises to almost 30 per cent for those in social high-risk groups.
• First Nations, Inuit and Métis women have a higher incidence of maternal depression than the general population.
• Half of the spouses of mothers suffering depression will also experience depression.
• Evidence suggests that the province spends more than $2 million each year on untreated maternal depression.

Unfortunately, the report notes, Saskatchewan does not have a provincial policy for maternal mental health. This means a lack of consistency when it comes to supporting mothers, their children and their families.

The MotherFirst report makes four recommendations:

1) Education – “Increase awareness of the frequency, impact, and treatment of maternal mental health problems, and promote positive mental health through ongoing access to evidence-based materials.”
2) Screening – “Universal screening for depression and anxiety using the Edinburgh Postnatal Depression Scale (EPDS) in pregnant and postpartum women.”
3) Treatment – “Prioritize maternal mental health within Mental Health Services, improve accessibility, and in¬crease treatment options.”
4) Sustainability/Accountability – “Implement the MotherFirst policy recommendations and ensure maternal mental health remains a priority within Saskatchewan.”

The report also includes examples of best practices in the province to go along with the recommendations. These include mothers’ groups in Assiniboia, Mortlach, and Biggar; the Battlefords Tribal Council Indian Health Services’ comprehensive mental health strategy; the Saskatoon Health Region’s Maternal Mental Health Program; and an intersectoral Maternal Mental Health Group in the Prairie North Health Region.

The full report is available on kidSKAN, as well as a fact sheet with information on symptoms, questions to ask, and how to get help. The report and many other resources are also available at the Maternal Mental Health website .

By Mike Chouinard, kidSKAN managing editor. He can be reached at mike.chouinard@usask.ca.