Screening and Referral Recommendations in Postpartum Depression

Opinion
Video

Panelists discuss how effective screening goes beyond formal tools like the Edinburgh Postnatal Depression Scale to include genuine patient connection, direct questioning about emotional well-being, and clinical observation, while emphasizing the important role pediatricians can play in identifying maternal mental health concerns during frequent baby visits.

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This segment provides practical guidance for health care providers on implementing effective screening strategies that go beyond standardized questionnaires to capture the full scope of perinatal mental health concerns. The experts address the common problem of patients learning to “game” screening tools by providing socially desirable responses, emphasizing that clinical observation and genuine patient connection are essential components of effective screening. They recommend looking for visual cues such as flat affect, excessive tearfulness, or lack of maternal-infant bonding behaviors that may indicate underlying mental health concerns.

The panel advocates for a more personalized approach to screening, suggesting questions like “How are you really?” and “How are you upstairs and downstairs?” while emphasizing the importance of making genuine eye contact and taking time to sit with patients. They stress that many postpartum women rarely receive inquiries about their own well-being, as most interactions focus on the baby’s health and development. This approach requires providers to create safe spaces where patients feel comfortable disclosing their struggles without fear of judgment or consequences.

The discussion highlights the expanding role of pediatricians in perinatal mental health screening, as they see families more frequently during the postpartum period than obstetric providers. Some pediatric practices have begun administering screening tools like the Edinburgh Postnatal Depression Scale to mothers during infant visits, recognizing their unique position to identify struggling parents. The experts emphasize that perinatal mental health is everyone’s responsibility, requiring collaboration between obstetric providers, primary care physicians, pediatricians, and mental health professionals to create a comprehensive safety net for vulnerable families during this critical period.

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