Pregnant and Postnatal Women Should Be Screened for Depression, Says U.S. Govt
Women should be screened for depression before and after childbirth, the US government recommended on Tuesday.
Screening for depression in new mothers, currently a relatively rare occurrence, usually involves health providers asking patients a series of questions to evaluate their mental health, asking whether they are feeling down or struggling to concentrate, for example.
The new recommendation from the US Preventive Services Task Force is not mandatory but is the biggest public health acknowledgement in the US to date of the importance of screening for mental health in pregnant and postnatal women.
“Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment and appropriate follow-up,” reads the recommendation.
Postnatal depression support groups welcomed the change.
“There’s a lot of evidence that shows that pregnancy and the first year has more impact on a child’s future than any other time,” said Katherine Stone of Postpartum Progress, a blog and non-profit.
“If you don’t ensure mom has good emotional health in pregnancy and first postpartum year, you’re already hampering the health of these children and their cognitive development,” said Stone.
But she also noted that screening would not fix everything; the country suffers from a lack of mental health care professionals and the recommendation does not include any extra cash.
By contrast, UK prime minister David Cameron recently pledged £290m ($416m) for perinatal (before and after birth) mental health care.
Stone herself suffered postnatal depression following the birth of her son 14 years ago.
“From being this competent, educated women with an amazing career and a wonderful marriage, suddenly I’m in hell. It’s like your whole life is rearranged and you’re convinced it’ll never end,” she said.
She was never screened by doctors for depression before or after her pregnancy and says that as someone who normally trusts doctors, she would have answered honestly if a health professional had asked her about how she was feeling.
But Stone pointed out that lower-income women, immigrant women and women of color, who may mistrust or have suffered discrimination from health professionals, are at a higher risk of getting missed during mental health screenings.
Randy Gibbs of California is another person who has been personally touched by the effects of perinatal mental disorders.
His family founded the non-profit Jenny’s Light, which helps to provide information on mental health for new mothers, in honor of his younger sister Jenny Gibbs Bankston.
On 19 December 2007, Bankston took her six-week old son along with her to the gun store, where she purchased a gun. That night she went into the backyard and shot her son and then herself, killing them both.
“She kept her symptoms such a secret, and then it turned into postpartum psychosis,” said Gibbs.
Gibbs said 1 in 1,000 new moms suffer postpartum psychosis. “They’re not in reality anymore. Jenny did what she thought was the right thing to do,” he said.
He welcomed the new screening recommendations, noting that even if women did not honestly answer the mental health questions, the fact that depression was becoming a standard thing for doctors to screen for meant the new mothers might go home and tell their partners or parents about the symptoms they were experiencing.
“Just the idea of having a screening test program in place, it kind of validates that it is an actual illness,” said Gibbs.
“Right now it’s like a secret that no one wants to talk about. It’s in the shadows. It’s not like cancer or leukemia or other things you can physically see.”
His sister never received any screening for mental health or depression, although her family found evidence after her death of her searching the internet for information about postpartum depression.
Asked what he thought would have happened had Bankston been screened for depression, Gibbs said: “We wouldn’t be talking on the phone right now.”