Perinatal mental health screening in Australia

For many women, having a baby is an exciting time. But for some, pregnancy and the first year of their baby's life (together known as the perinatal period) can be a challenging experience. While it’s normal to sometimes experience ups and downs due to the challenges of adjusting to parenthood, having a perinatal mental health condition is different – it is more severe and will usually not improve without treatment.

Mental health conditions during the perinatal period are common, affecting an estimated 1 in 5 mothers and can have serious effects on the health and wellbeing of women, their babies and families. Depression and anxiety are common perinatal mental health conditions experienced during the perinatal period with impacts ranging from mild to severe. In 2019, these 2 conditions are estimated to have cost Australia $877 million from increased health care costs associated with increased service use, and productivity losses from reduced economic participation (Highet et al. 2023; PwC Consulting Australia 2019). Other severe mental health conditions, such as schizophrenia and bipolar disorder, are less common but have high comorbidity with other mental health conditions and are associated with a range of adverse outcomes (Highet et al. 2023).

National guidelines recommend that all women are screened for signs, symptoms and risk factors of mental health conditions during the perinatal period, to help ensure women receive timely support and treatment (Highet et al. 2023). However, there are currently no national data about perinatal mental health screening, service use or outcomes. 

Perinatal mental health screening involves a range of health services, government and non-government organisations. State and territory health departments have an important strategic role in developing policies and guidelines relating to perinatal mental health assessment and treatment, these may be implemented differently within individual health services responsible for conducting screening. Opportunities to conduct perinatal mental health screening depend on the type and timing of maternity services accessed during the course of a mother’s pregnancy. 

Data about the mental health of parents in the perinatal period are collected by a range of health services, government and non-government organisations mostly as a by-product of delivering maternity services. This information is not collected consistently across Australia, with differences in how, when and if screening occurs. Previous research indicates that the proportion of mothers receiving mental health screening has increased over time but has highlighted particular cohorts that have been underrepresented, such as Aboriginal and Torres Strait Islander (First Nations) women, women born overseas, single or separated women, private patients and older mothers (Moss et al. 2020; San Martin Porter et al. 2019).

This report focuses on perinatal mental health screening, including whether screening occurred and identified risk factors, for 4 state and territory health authorities and explores how these vary by maternal characteristics and behaviours, birth settings, care types and birth outcomes. This includes, for the first time, analysis of models of care provided to women in Queensland and detailed antenatal mental health and family violence risk factor screening data from New South Wales public health services. It also describes efforts to improve data collection and reporting to build a national picture about perinatal mental health screening that can inform the development and evaluation of policies, services and initiatives to better support mothers and their families.