Postnatal Depression can be prevented by Health Visitors, says new study
News release from NETSCC, HTA
20 August 2010
Training health visitors to assess and psychologically support mothers after childbirth can prevent the development of depression over the following year finds the prevention study.
The study analysed data collected from the PoNDER clinical trial, funded by the NIHR HTA programme. This trial, led by Dr Jane Morrell, now at the University of Nottingham, tested the effectiveness of health visitors in identifying and managing postnatal depression following child birth.
While the PoNDER treatment trial was published in the BMJ in 2009, the research into prevention of depression required additional collaborative analysis by the authors of this new scientific paper which has now published separately in the Cambridge University Press’ journal Psychological Medicine.
The ‘prevention study’ was led by Professor Terry Brugha of the University of Leicester with researchers from the universities of Nottingham and Sheffield. It is the first large scale randomised trial to show a statistically significant reduction in future cases of depression in women living in the community who were not depressed when they joined the study.
Lead author Professor Brugha, commented: “Up until now, it was thought that depression could only be treated when it is picked up by a GP or health visitor. But this study shows that women are less likely to become depressed in the year after child birth if they are attended by an NHS health visitor who has undergone additional training in specific mental health assessment and in psychological approaches based on either cognitive, behavioural, or listening techniques.
Professor Brugha continued: “Women receiving usual care were significantly more likely to develop depression six months after childbirth. However, when the research team set out to repeat and develop this research further they were unable to make sufficient progress because in most parts of England there has been a substantial reduction in the number of health visitors funded by the NHS. Mothers were fortunate if they received just one home visit from a health visitor. Health visitors were unable to take time off to undergo the extra training in assessment of depression and psychologically support approaches. Therefore, the research team at the University of Leicester is now considering undertaking further research on prevention of postnatal depression in other parts of the world.”
Other key findings were:
• Women who had a health visitor with additional mental health training, were 30 per cent less likely to have developed depression six months after child birth compared to control women in the control group receiving usual care.
• The results suggest that these improvements continued throughout the eighteen month follow-up. Even women who had few or no complaints of depression at six weeks following child birth appeared to benefit later if their Health Visitor had additional training.
Notes for editors
1. The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme commissions research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 530 issues published to date. The journal’s 2009 Impact Factor (4.197) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk
2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk
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Telephone: 02380 599 094, Email: E.Sunderland@southampton.ac.uk
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