• By Dartington SRU
  • Posted on Thursday 10th November, 2011

Could peer supporters be a solution to postnatal depression?

Postnatal depression affects about 13 in every 100 women having a baby. With such a high rate of need, many women with postnatal depression (PND) in the UK go unsupported – especially those who feel unable to admit their problems and those whose PND is not perceived as severe enough to warrant treatment. Worse, PND can be disabling for the mother and bad for the baby: it can damage the relationship between the mother and her baby and harm the child’s behavioral and cognitive well-being. How can health services bridge this major public health gap? The fact that postnatal depression does not usually have a single cause, but is the result of a combination of factors, may point the way forward. Causes of PND may include the need to talk to someone who has experienced similar problems, having no close family or friends to confide in, the need for support without having to ask for it, and social isolation. This is where peer supporters may be valuable, researchers at Warwick University, UK, suggest. Women who have had similar experiences may be in a position to better relate to new mothers who suffer from PND. People are often more inclined to receive assistance and encouragement from individuals whom they consider to be equals, and the practical advice and coping strategies that peer supporters may have to offer could be vital for mothers who need help. Mums4Mums: telephone peer-support interventionThe feasibility and effectiveness of peer support for PND is set to be tested in an upcoming exploratory study. A group of researchers at Warwick University (UK) have adapted a Canadian telephone peer-support intervention for use in the UK. The study aims to test the use of the new intervention, called Mums4Mums, and to provide preliminary data on whether it reduces depressive symptoms in mothers experiencing PND. Prior to the trial proposal, the research conducted interviews with doctors, health visitors, and mothers who had recovered from PND to explore whether a telephone-based peer-support intervention would be acceptable. The researchers were also interested in interviewees’ views on the potential impact of the intervention and how it would fit into current practice. The stakeholders agreed there was a need for this kind of additional resource, and welcomed its flexibility and use of non face-to-face contact. The intervention was also piloted with eight mothers currently living with PND. Interviews with these women suggested that the intervention was “acceptable and likely to be beneficial in supporting women with PND.” Based on those encouraging pilot studies, the current Mums4Mums feasibility trial has begun with the recruitment of 18 peer supporters. These women had recently experienced postnatal depression and fully recovered from it, had an “empathic and non-judgemental disposition,” and had time to participate in training and provide telephone support. The 18 participants each received eight hours of training to help them understand the role, develop their confidence, and learn more about active listening and promoting successful behavior change. Now, 30 women with PND are being recruited for the study. All participants will receive standard care from their doctor and health visitor. Women in the intervention group will also receive support calls over a period of four months from peer supporters. In addition to looking at primary outcomes such as change in depressive symptoms and maternal functioning, the study will also explore mothers’ perceptions of the telephone peer support. Furthermore, a random sample of stakeholders will be interviewed to get their views on the “acceptability and feasibility of the intervention for participants, peer-supporters and health visitors.” The telephone-based peer-support intervention has potential not only to reduce the symptoms of postnatal depression in mothers but also to improve mother-infant relationships, which could, in turn, also have an impact on later emotional and behavioral adjustment in the early years, especially in the case of disadvantaged boys. Farther down the road, the results of poor emotional and behavioral adjustment can include delinquency, drug abuse, and a range of mental health problems. Thus, early intervention for postnatal depression could not only improve outcomes for mothers and children, but also have a long-term impact on health service use. References:Caramlau, I., Barlow, J., Sembi, S., McKenzie-McHarg, K., & McCabe, C. (2011). Mums 4 Mums: structured telephone peer-support for women experiencing postnatal depression. Pilot and exploratory RCT of its clinical and cost effectiveness. Trials, 12, 88.

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