Barriers to antenatal psychosocial assessment and depression screening in private hospital settings
Abstract
Problem The evidence of benefit for antenatal psychosocial assessment and depression screening has been sufficient to lead the implementation of screening in public hospitals in all states of Australia. Details of the implementation of perinatal screening in private obstetric settings is less well known.Aim As any successful implementation relies on the identification of local barriers, we aimed to determine what perceived or actual barriers may exist for the implementation of evidence-based perinatal screening interventions in private obstetric care, and specifically within small private hospitals.Method The integrative literature review method offers a structured systematic approach to organise, synthesize and critique research from a range of sources. This method was used to determine what barriers have been identified in implementing psychosocial assessment and depression screening with women receiving obstetric care in private hospital settings.Findings The integrative review findings suggest that barriers to implementing psychosocial screening in the private sector are similar to those experienced in the public sector but may also be influenced by the corporate focus of private services. Barriers were identified among health professionals, within the personal and psychosocial context of women and their families, and at provider or system level.Conclusion Once identified, barriers can be systematically addressed to enhance the success of implementing psychosocial and depression screening in the private sector. Screening is likely to be influenced by the business models and operating systems of private service providers. Health professionals working within this environment need more support to conduct perinatal assessment within this context.
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As many as half of patients are either not screened or misdiagnosed before delivery.
“Studies show that as many as 50% of patients are not screened or are misdiagnosed prior to delivery69,70.”
From Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications (2021) · cites this paper as [70]
Screening rates for antenatal mood disorders are low both on antenatal units and in outpatient settings.
“Screening rates for antenatal mood disorders, on antenatal units and in the outpatient setting, are low.”
From Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications (2021) · cites this paper as [70]
Screening rates for perinatal mental health conditions are low in all settings.
“Additionally, despite recommendations to universally screen for perinatal mental health conditions [31], screening rates are low in all settings [24, 32]”
From Factors associated with postpartum depression symptoms following antepartum hospitalization (2026) · cites this paper as [24]
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- Authors
- Connell, T., Barnett, B., & Waters, D.
- Affiliations
- The University of Sydney (AU)
- UNSW Sydney (AU)
- Corresponding author
- Connell, Tanya
- Venue
- Women and Birth
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 31
- Issue
- 4
- Pages
- 292-298
- ISSN
- 1871-5192 (ISSN-L)
- OpenAlex
- W2764033823
- Cited by
- 35
- References
- 26
- Citations by year
- 2026: 3 · 2023: 7 · 2022: 5 · 2021: 12 · 2020: 4 · 2019: 3 · 2017: 1
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Women and Birth (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- implementation barriers, private hospitals, perinatal screening, health worker support
- MeSH terms
- Adult, Attitude of Health Personnel, Australia, Depression, Female, Humans, Mass Screening, Middle Aged, Poverty, Pregnancy, Pregnancy Complications, Prenatal Care, Psychiatric Status Rating Scales, Hospitals, Private, Risk Assessment
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