Having worked as a local health visitor for several years in Orpington, Lily Foyster identified a great number of clients suffering from postnatal depression and also the lack of support facilities available. She describes how a joint approach with the local community mental health service can meet women's emotional support needs.
Evaluation of a health visitor project in Sevenoaks demonstrated both the value of the Edinburgh postnatal depression scale (EPDS) in the identification of postnatal depression, and the positive benefit of health visitor intervention in its early stages. But, as Angela Painter reports, the project also underlined the need for a ten-week home visit and the obstacles presented by large caseloads, poor liaison with other services and purchaser reluctance.
Women suffering postnatal depression frequently report the additional stress of feeling they are alone in their distress. Access to a regular support group to discuss their problems with peers can be valuable. Fawnia Pitts describes one such health visitor-led group, evaluation of which suggests it is both effective and cost-efficient in helping women through postnatal depression.
Health visitors and lay people have been working together in Maidenhead to support women suffering from postnatal illness. Alison Jones, Tricia Watts and Sybil Romain describe how the group supplements medical and psychiatric services, by tackling the isolation women with postnatal depression can feel, and helping them through until the illness ends.
Many health visitors, GPs and midwives feel frustrated in their attempts to help women suffering from postnatal depression, due to a lack of consensus concerning diagnosis and treatment. Mary McClarey and Beverley Stokoe outline how an awareness that these and other women's mental health needs were not being met led to the launch of the Oxford city postnatal depression strategy in April.
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