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Health services research into postnatal depression: results from a preliminary cross-cultural study

Health Services Research Department, Institute of Psychiatry, London

Sue Conroy, MSc

Section of Perinatal Psychiatry, Institute of Psychiatry, London, UK

Nine Glangeaud-Freudenthal, PhD

Research Unit 149, INSERM, Villejuif, France

Margaret R. Oates, MB, FRCPsych

Division of Psychiatry, University of Nottingham

Paul Asten, MHSc

Section of Perinatal Psychiatry, Institute of Psychiatry, London, UK

Siobhan Barry, MRCPsych, MD

Cluain Mhuire Family Centre, Co. Dublin, Ireland

Barbara Figueiredo, PhD

Department of Psychology, University of Minho, Braga, Portugal

Martin H. Kammerer, Dr med

Child and Adolescent Psychiatry, University of Zurich, Switzerland

Claudia M. Klier, MD

Department of Psychiatry, University of Vienna, Austria

Gertrude Seneviratne, MRCPsych

Section of Perinatal Psychiatry, Institute of Psychiatry, London, UK

Anne-Laure Sutter-Dallay, MD

University Department of Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France

TCS–PND Group^*

Correspondence: Dr Dan Chisholm, Global Programme on Evidence for Health Policy, World Health Organization, 1211 Geneva, Switzerland. E-mail: ChisholmD{at}who.int

Declaration of interest None.

^* TCS–PND Group membership and funding detailed in Acknowledgements, p. iv, this supplement.

Background Little is known aboutthe availability and uptake of health and welfare services by women with postnatal depression in different countries.

Aims Within the context of a cross-cultural research study, to develop and test methods for undertaking quantitative health services research in postnatal depression.

Method Interviews with service planners and the collation of key health indicators were used to obtain a profile of service availability and provision. A service use questionnaire was developed and administered to a pilot sample in a number of European study centres.

Results Marked differences in service access and use were observed between the centres, including postnatal nursing care and contacts with primary care services. Rates of use of specialist services were generally low. Common barriers to access to care included perceived service quality and responsiveness. On the basis of the pilot work, a postnatal depression version of the Service Receipt Inventory was revised and finalised.

Conclusions This preliminary study demonstrated the methodological feasibility of describing and quantifying service use, highlighted the varied and often limited use of care in this population, and indicated the need for an improved understanding of the resource needs and implications of postnatal depression.

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