An Evaluation Of Perinatal Mental Health Services In Rural And Regional Australia: A Scoping Review

Anisha Gandhi¹, Dr Alexa Seal¹
1. The School of Medicine, The University of Notre Dame Australia

Background:

Suicide continues to be a leading cause of maternal death in Australia (Australian Institute of Health and Welfare, 2024). National guidelines for Perinatal Mental Health (PMH) emphasise the importance of screening for mental illness throughout the perinatal period to ensure timely referral and treatment (Centre of Perinatal Excellence, 2023). Access to PMH services vary with setting and location, making timely treatment challenging, particularly in rural and remote areas (Centre of Perinatal Excellence, 2023). There is a research gap in evaluating the current state of PMH services in rural and regional Australia. This research aims to evaluate the availability and accessibility of PMH services in an Australian rural and regional context, while also outlining the barriers and facilitators to accessing PMH interventions in these settings.

Methods:

A comprehensive search strategy using four electronic databases was undertaken. Relevant studies were sourced from peer review databases using key terms related to perinatal mental health, interventions and regional/rural settings. Search results were screened on title, abstract and full text to assess those meeting inclusion criteria and relevance to the research question. After screening, 28 articles were included in the scoping review.

Results:

The literature revealed a noticeable gap in access amongst women from rural and disadvantaged backgrounds, despite higher clinical need (Austin et al. 2022). Compared to women living in major cities, women residing in regional and remote areas had a lower total number of mental health consultations during the perinatal period and accessed a lower proportion of psychiatric consults (Chambers et al., 2018). There were several barriers to PMH care noted, including limited resources and funding, system complexity, navigation challenges and lack of awareness regarding services amongst clinical staff and women. Key facilitators to PMH care in regional and rural settings included use of technology, additional funding, continuity of care, and culturally safe care. A variety of unique regional and rural services were noted throughout the literature and fell into the brackets of national, statewide and local models of care (MOC).

Conclusion:

Access to PMH services varies greatly geographically and accessibility remains to be a key challenge in rural and regional settings. Facilitators to providing effective PMH care largely involves embracing technology and community-driven models. Future recommendations to improve PMH in rural and regional settings include 1) increasing clinician awareness of current outreach and navigation programs, 2) upskilling midwives and MCH nurses and 3) increasing funding to upscale and widely implement current successful MOC.