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Objective: To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare services for women at risk of perinatal mental illness., Method: Retrospective cohort study using difference-in-difference analytical methods to quantify the impact of the National Perinatal Depression Initiative policies on Medicare Benefits Schedule mental health usage by Australian women giving birth between 2006 and 2010. A random sample of women of reproductive age enrolled in Medicare who had not given birth where used as controls. The main outcome measures were the proportions of women giving birth each month who accessed a Medicare Benefits Schedule mental health items during the perinatal period (pregnancy through to the end of the first postnatal year) before and after the introduction of the National Perinatal Depression Initiative., Results: The proportion of women giving birth who accessed at least one mental health item during the perinatal period increased from 88 to 141 per 1000 between 2007 and 2010. The difference-in-difference analysis showed that while there was an overall increase in Medicare Benefits Schedule mental health item access as a result of the National Perinatal Depression Initiative, this did not reach statistical significance. However, the National Perinatal Depression Initiative was found to significantly increase access in subpopulations of women, particularly those aged under 25 and over 34 years living in major cities., Conclusion: In the 2 years following its introduction, the National Perinatal Depression Initiative was found to have increased access to Medicare funded mental health services in particular groups of women. However, an overall increase across all groups did not reach statistical significance. Further studies are needed to assess the impact of the National Perinatal Depression Initiative on women during childbearing years, including access to tertiary care, the cost-effectiveness of the initiative, and mental health outcomes. It is recommended that new mental health policy initiatives incorporate a planned strategic approach to evaluation, which includes sufficient follow-up to assess the impact of public health strategies., (© The Royal Australian and New Zealand College of Psychiatrists 2015.)

Objective: To establish a benchmark of awareness, knowledge and attitudes in Australia in relation to depression and its treatment in the perinatal period, and to identify demographic factors associated with perinatal mental health literacy., Method: A cross-sectional telephone survey (n = 1201) of a randomly selected sample of adults in each State and Territory of Australia, conducted in late 2009., Results: Depression was the most frequently cited general health problem for women after childbirth (43.6% of spontaneous responses), in contrast to previous findings of low awareness of depression generally. A total of 94% of adults believed that postnatal depression requires specialized treatment. Older Australians (55 + years) identified postnatal depression less readily than younger Australians. Although well recognized as a specific mental health issue, as a general health issue antenatal depression had low recognition and was viewed by 52% of respondents as 'normal'. Community beliefs about perinatal rates of depression appeared realistic. Men and women differed in their knowledge and beliefs about the symptoms and causes of postnatal depression. Difficulty in mother-infant bonding was seen as a common sign of postnatal depression, particularly by women. Most commonly, postnatal depression was perceived as having a biological rather than psychosocial etiology (30% of men, 41% of women). Recognition of anxiety in the postnatal period was relatively low, although higher among those with mental health training. Over 80% of Australians believed that all new mothers should be routinely assessed for depression., Conclusions: Awareness of postnatal depression appeared to be at a high level in the community, but both anxiety and antenatal depression were comparatively under-recognized, suggesting there is considerable scope for awareness-raising. Established risk factors for postnatal depression were not coherently recognized. Ongoing tracking of perinatal mental health literacy in Australia is likely to be valuable in assessing the impact of future public awareness efforts.

Objective: This report records the level of exposure to depression-related information across the Australian community and explores associations with recognition of depression and relevant sociodemographic factors., Method: A cross-sectional telephone survey was conducted with a representative community sample. Participants consisted of 3200 respondents (400 respondents across each Australian State/Territory)., Results: Sixty-five point four per cent (n=2089/3193) of respondents indicated that they or someone close to them had experienced depression, of whom 18.7% (n=391/2089) reported a personal experience of this illness. Various measures of recent exposure to depression-related information were high with 69.0% (n=2207/3200) reporting that they had seen, read or heard something in the media in the last 12 months. Recognition of beyondblue: the national depression initiative was also surprisingly high (61.9%, 1982/3200). Those with greater understanding that depression is common and debilitating were more likely to recall recent media stories, spontaneously recall relevant organizations such as beyondblue, to have had direct or family experiences, to be younger and to have achieved higher levels of education. Depression, however, is rarely mentioned (1.3%, 47/3720) as a major general health as distinct from a mental health problem., Conclusion: The active promotion of depression-related material to the community appears to have contributed to recognition of the commonality and impacts of this illness. Although depression is commonly recognized as a mental health problem, it is not yet considered a major general health problem. Further, like many public health campaigns, those initially reached appear more likely to be female, younger, better educated and residing in metropolitan areas.

Objective: To compare existing community treatments for post-partum depression (PPD), treatment efficacy was evaluated for 146 women seeking treatment for PPD in the local community., Methods: Self-report questionnaires were designed to assess clinical depression and anxiety (psychological and physiological), risk factors, treatment satisfaction and the impact of social supports., Results: Comparison of treated subjects with those on a wait-list demonstrated that depression and the psychological component of anxiety decreased significantly after treatment. Psychological and pharmacological interventions produced similar clinical benefit in the treatment of psychological symptoms, and receiving both treatments in combination was of no added clinical benefit in the immediate or longer term. Individual treatment was associated with more rapid treatment gains initially than group treatment. However, the benefits of group treatment emerged during the 6 months following treatment, leading both interventions to be equally effective in the longer term. Cognitive behavioural therapy was not superior to the combination of non-specific counselling or behavioural strategies, either immediately following treatment or 6 months later., Conclusions: Clinical efficacy together with other clinical and financial benefits strongly advocate the application of psychological treatment for PPD. Clear parallels between PPD and general depression support the application of knowledge about general depression to extend understanding of PPD and refine clinical management practices.