Dr Lisa Fodero, Dr Jacqui Poltera and Katrina Gray.
Health Consult Pty Ltd.
This project was funded under the National Perinatal Depression Initiative, which was a cost shared program between the Commonwealth and State and Territory Governments.
Request for proposal
Project completion year
This project aims to test the feasibility of a peer-to-peer storytelling model in reducing stigma associated with postnatal depression (PND) and increase help seeking behaviours amongst new mothers attending mothers’ groups.
In order to test the feasibility of this intervention, the project sets out to achieve the following objectives:
- Reduce self, personal and perceived stigma associated with PND in new mothers
- Increase new mothers’ intent to discuss with others, and seek help for PND
- Determine the acceptability of the intervention amongst new mothers and maternal and child health (MCH) staff
- Identify the most/least effective intervention components, plus critical success factors & challenges
- Determine the opportunity to embed the intervention session within existing MCH services
- Determine the need and opportunity to enhance MCH nurses’ knowledge and skills in the management of PND through professional development activities.
Data analysis considerations
The project was delivered in a total of six mothers groups in three MCH sites, therefore the quantitative data presented about stigma and help seeking behaviours are not significant.
There were variations in the planning and delivery of the project across sites, which is likely to have affected the final results. These variables were:
- Variable group dynamics across groups
- Variable socio-economic demographics across groups
- Variable levels of relatability between mothers and the speakers
- Inconsistent session delivery by staff across sites
- Inconsistent data collection by staff across sites.
Stigma and help seeking
- Our quantitative data suggested that following the control sessions, mothers had a reduction in self-stigma in all subscales (Shame, Self-blame and Help-seeking inhibitions). Following the intervention sessions, mothers increased in self-stigma in two subscales (Self-blame, Help-seeking inhibitions) and decreased self-stigma in one subscale (Shame).
- In both the control and intervention sessions, mothers increased in their willingness to seek help for personal and emotional problems and suicidal thoughts.
- Mothers reported a number of benefits that came out of both the control and intervention sessions, which were: increased awareness of what PND is and what help is available; improved knowledge of the signs and symptoms; learned strategies to deal with PND; and gaining learnings from others’ experiences.
- There were additional benefits reported by those attending the intervention sessions such as: the speaker normalising the discussion about PND, which enabled mothers to open-up about their own experiences; and that the speaker providing real-life insights into their experiences of treatment, which helped mothers to manage their expectations about their journey to wellness.
- Some mothers in the groups were not able to relate to the peer speakers. In regards to the relatability of the speakers, mothers thought that the speaker’s cultural and socio-economic background was less important than: the speaker’s ability to engage with the group; the closeness in the speaker’s age to group members; and for speakers to share fairly similar pregnancy dates with the mothers they’re speaking to.
This highlights the importance of ensuring peer speakers are relatable and able to effectively engage with their audiences to effectively address stigma. This may require additional training for speakers who attend certain vulnerable groups.
Maternal and Child Health (MCH) Staff
- There was a highly variable level of support for the intervention from MCH staff at different sites. Some staff highlighted the importance of providing information about PND to mothers and affirmed the value of having a speaker involved to reinforce messaging about PND. While staff from other sites were extremely reluctant to share information about PND and reported a peer speaker was not necessary, as they could run the sessions themselves.
- Some of the negative staff attitudes towards the project were reflected (almost word-for-word) from the mothers in the mothers focus groups - suggesting a ‘flow on’ effect of staff attitudes through to mothers.
This highlights the importance of MCH staff being aware of their attitudes towards PND, as their views can have a flow on effect to mothers and impact on mothers’ levels of stigma and willingness to seek help.
Download the executive summary of the Final Evaluation Report.
Download the full report.