Motivational Interviewing Improves Help-seeking for Postnatal Depression and Anxiety

LATEST RESEARCH FINDINGS

PIRI conducted a study in collaboration with Maternal and Child Health Services in the Cities of Banyule, Whittlesea and Moonee Valley, to examine whether a brief motivational interviewing (MI) intervention delivered by Maternal and Child Health Nurses (MCHNs) during routine postnatal visits improves help-seeking following childbirth. Studies consistently report concerningly low levels of treatment uptake by women showing symptoms of emotional distress during the postnatal period. At most, only 50% of women who are distressed postnatally seek treatment.

In this study, 20 MCHNs were trained in motivational interviewing and another 20 MCHNs continued to provide women with routine care. In total, 541 women were recruited to the study. Of these, 27.4% experienced emotional distress over the 12 months post-birth. When women experienced emotional distress in the 12 months post-birth, the odds of seeking help were 4 times higher for those who received Motivational Interviewing than for those who received routine care. Of the women who sought help from a psychologist, 47.6% in the MI condition attended 6+ sessions, compared with only 20.0% in the routine care condition, suggesting better adherence to treatment in the MI condition. There was a non-significant trend of lower depression, anxiety and stress in the MI condition. Common barriers to seeking help were thinking that one would or should be able to manage without help (endorsed by 11.1% of the sample).  Feedback from the MCHNs in the study was that the MI intervention was useful to their practice and they felt confident delivering it. In both the MI and routine care conditions, women found the discussions they had with their MCHN about their emotional well-being to be helpful.

These results suggest that treatment uptake for postnatal distress can be increased with a brief MI intervention delivered by MCHNs. Results showed that training MCHNs in MI was feasible and valued. Given the devastating effects of postnatal depression, further research is needed to ascertain whether MI can improve mental health outcomes in addition to increasing help-seeking.

REFERENCE: Holt, C., Milgrom, J., & Gemmill, A.W. (in press). Improving help-seeking for postnatal depression and anxiety: A cluster randomised controlled trial of Motivational Interviewing. Archives of Women’s Mental Health.