Vision, Mission & Aims
Perinatal Mental Health Project
Under the banner, 'Caring for Mothers, Caring for the Future', the Perinatal Mental Health Project (PMHP) was established in 2002 as a pilot project to address mothers with post-natal depression. The project operates out of the Maternity Hospital in Mowbray, Cape Town, and was designed to care for mothers from informal settlements.
The Perinatal Mental Health Project (PMHP) aims to provide a holistic mental health service to pregnant and postpartum women at the site at which they receive obstetric care. To achieve this it hopes to identify women at risk of, or currently suffering from, perinatal mental distress. Counseling is offered to prevent or alleviate symptoms and to improve the sequelae of perinatal mental health disturbances for women, their infants and communities. Early detection, appropriate treatment and management of mental-health problems during and after pregnancy form the basis for the project and its intervention.
Postpartum depression has been shown to have severe negative effects on the health and well being of infants after birth including low birth weights, poor mental development, and hyperactivity. Pregnant women who are HIV- positive are particularly vulnerable to mental health problems during pregnancy. With the help of multi-lingual mental health screening questionnaires administered at the second visit, with consent from the mothers to be, specially trained midwives at Liesbeek Midwife Obstetric Unit are able to detect possible mental health problems in pregnant or postpartum women and provide counseling.
The project was designed according to the South African Mental Health Care Act of 2002. Furthermore, the Act states that access to mental-health services should be integrated into the general health-services environment. In addition, the project also provides training and resources for perinatal mental health at all maternity units in Cape Town, and provides a platform for research into disciplines concerning perinatal health. The project has involved a wide range of medical staff, community organisations and other civil society organisations (e.g. NGOs). The PMHP has been funded by the Western Cape Department of Health, the EU Lilly Foundation and the Winnicott Foundation.
Innovation
During pregnancy, women come into contact with medical professionals on a regular and frequent basis, providing an ideal opportunity for intervention for women with mental health problems who would not otherwise have access to those services. In the setting of antenatal visits, screening for problems becomes routine, and the woman is therefore able to obtain help in a non-threatening environment without having to expend additional resources.
Effectiveness
During the first two and half years of the pilot project, 1700 women were screened and about 300 women were counseled. Staff and perinatal mental health clients alike gave positive feedback about the service. The project has received commendations from the WTO and the World Federation for Mental Health.
Poverty Impact
The project stands to benefit mothers by providing them with access to mental health screening and care. This aspect of care is usually unavailable to women using the public health sector. The results for impoverished women in the programme are lower levels of anxiety and depression, lower use of alcohol and drugs, increased ability to access community-based resources for ongoing care, a more positive birth experience, easier bonding with their babies, prolonged breastfeeding, and a lower likelihood to resort to child abuse and suicide.
Sustainability
The PMHP currently receives a lot of help from volunteers and health workers contributing time on top of their other jobs and responsibilities. Certain donations are received on an ad hoc basis, while the provincial department of health contributes the majority of the funding. In order for this programme to remain sustainable, the government will have to continue to contribute larger amounts of money in order to maintain permanent experienced staff. In addition, the project is looking to be registered as an NPO in order to attract this funding.
Replication
One case of replication is already being carried out at a site identified in Hanover Park at the Cape Flats. The PMHP is most definitely a replicable programme, satisfying a demand in the mental health sector. Sufficient funding and the enthusiasm from communities and health workers are essential in potential replication cases.
Partnerships
• Western Cape Department of Health
• EU Lilly Foundation
• Winnicott Foundation
