Importance and availability of national perinatal mental health screening data
Consistent, nationally collected perinatal mental health screening data helps build the evidence about women’s exposure to risk and protective factors, presentation patterns (before, during and after pregnancy), and health outcomes for mothers and babies across Australia. It enables targeted initiatives, service coordination and delivery, and further research and evaluation to ensure that women and families receive the care they need when they need it, particularly for priority population groups.
Mental health and family violence Perinatal National Best Endeavours Data Set items
The Australian Institute of Health and Welfare (AIHW) started investigating the feasibility of including antenatal mental health and family violence screening data in the National Perinatal Data Collection (NPDC) in 2010. The NPDC includes the Perinatal National Minimum Data Set (NMDS), a collection of mandatory data items that state and territory health authorities have agreed to supply, and the Perinatal National Best Endeavours Data Set (NBEDS), a collection of data items that are not mandated for national collection but for which there is a commitment to provide data nationally on a best endeavours basis. Several antenatal mental health and family violence data items were developed and refined in consultation with subject matter and data experts between 2013 and 2019. Voluntary implementation of the following 4 mental health and family violence data items commenced July 2020 through the Perinatal NBEDS 2020–21:
- Antenatal mental health risk screening status (Metadata Online Registry (METEOR) identifier 733468)
- Indication of possible symptoms of depression at an antenatal care visit, Edinburgh Postnatal Depression Scale (EPDS) score (METEOR identifier 704384)
- Presence or history of mental health condition indicator (METEOR identifier 622450)
- Family violence screening status (METEOR identifier 733542).
State and territory health authorities are working to implement the four voluntary mental health and family violence Perinatal NBEDS items into their perinatal data collections, and the AIHW is working with them to refine specifications (where required) and progress the items to the mandatory Perinatal NMDS. Data about the postnatal period after discharge are out of scope for the NPDC.
Perinatal Mental Health pilot
The AIHW is working with state and territory health authorities to develop the Perinatal Mental Health pilot (PMHp), a novel collection of de-identified screening data from public antenatal and postnatal maternity health services. This project is piloting the collection of de-identified clinical data for research purposes in a faster way, compared to traditional data flow pathways, by collecting data through a range of sources. These include existing perinatal mental health data supplied directly from state and territory health authorities, and data collected from participating public maternity services using the Centre of Perinatal Excellence’s (COPE) iCOPE screening platform. The iCOPE platform includes questions from the EPDS, Antenatal Risk Questionnaire (ANRQ) and other screening tools and facilitates automated clinical scoring and consistent data collection.
The PMHp is being established as Local Hospital Networks (LHNs) and state and territory health authorities confirm their interest to participate. The PMHp aims to complement and potentially support the refinement of the NPDC, by collecting data that is currently out of scope for the NPDC.