Daymark Foundation response to the Canadian Task Force on Preventive Health Care’s ‘Recommendation on instrument-based screening for depression during pregnancy and the postpartum period’
On July 25, 2022, the Canadian Task Force on Preventive Health Care released a recommendation against using questionnaires to screen all women and birthing people for depression during pregnancy and in the one year postpartum. This recommendation was based on the false assumption that usual care during the pregnancy and postpartum period includes inquiry and attention to mental health and well-being.
The Daymark Foundation is a private family foundation committed to transforming mental health, with a particular focus on perinatal mental health. Our exploration of this field has shown that, despite the fact that more than 20% of women and birthing people will experience symptoms of a perinatal mood or anxiety disorder during pregnancy or postpartum,[1] an estimated 75% of these cases are currently going undetected by healthcare providers.[2]
While we are not in a position to take a stance on the use of standardized screening tools, we do agree that usual care should involve inquiry into mental health and well-being. We therefore stand behind our grantees and partners who reject the Task Force’s recommendation, as it is based on entirely false assumptions about the current state of routine care.
Here are some ways the Daymark Foundation is ensuring that perinatal mental health issues are detected and treated:
Supporting the Canadian Perinatal Mental Health Collaborative (CPMHC) to advocate for increased access to perinatal mental health care. In 2021, CPMHC released their Time for Action report, which outlined current gaps in identification and treatment for women and birthing people, along with a lack of knowledge and capacity among healthcare providers to address mental health issues
Supporting the Society of Obstetricians and Gynaecologists of Canada to develop clinical guidelines on perinatal mental health. This includes a needs assessment of perinatal health providers on their current knowledge and capacity to detect mental health issues, along with guidance and tools on how to assess and respond to mental health concerns
Supporting Mommy Monitor to increase access for Black families to culturally sensitive perinatal care. Black mothers experience postpartum depression at twice the rate of the general population, but are more likely to be overlooked due to systemic discrimination in the healthcare system.[3]
We hope that any stakeholders poised to make a decision based on the Task Force’s recommendation will consider the true, dire state of perinatal mental health identification and treatment in Canada. As an intermediate step, we encourage engagement with perinatal mental health experts and those with lived experience on how to ensure that all healthcare providers actually do inquire about mental health and wellbeing, in some way, shape or form.
Published August 4, 2022
References
[1] Government of Canada, Statistics Canada. Maternal Mental Health in Canada, 2018/2019. 24 June 2019, https://www150.statcan.gc.ca/n1/daily-quotidien/190624/dq190624b-eng.htm.
[2] “Maternal Mental Health Overview.” The Maternal Mental Health Fact Sheet, Maternal Mental Health Leadership Alliance, July 2020, https://www.mmhla.org/wp-content/uploads/2020/07/MMHLA-Main-Fact-Sheet.pdf.
[3] “Maternal Mental Health: Black Women & Birthing People.” The Maternal Mental Health Fact Sheet, Maternal Mental Health Leadership Alliance, Nov. 2021, https://www.mmhla.org/wp-content/uploads/2021/11/Black-Women-Birthing-People.pdf.