Grant: Catalyst Grant: eHealth Innovations

WHAT WE KNOW. Mental health problems are the most common complications women experience during pregnancy or after having a baby. Yet, less than 20% of healthcare providers screen women for depression and anxiety during routine prenatal and postpartum care. As a result only 10% of pregnant and postpartum women in Canada with mental health problems receive help. Untreated mental health problems have serious, longlasting consequences. They can affect children's development and mental health-even into adolescence. There is then an urgent need to screen all pregnant and postpartum women for mental health problems to ensure that women access the care they need. WHAT WE WANT TO LEARN. The mental health system is strained. Implementation of screening as part of routine prenatal and postpartum care is unlikely to be successful if additional human resources are required. We want to learn if online 'e-screening' can be used in place of face-to-face screening by a healthcare provider. This would allow providers to concentrate on aspects of mental healthcare requiring high levels of skill and judgement, including in-depth follow-up assessment (after a woman is identified by screening with mental health concerns) and treatment. We will conduct a randomized controlled trial at two unique clinics that conduct mental health screening. Pregnant and postpartum women in the experimental group will complete mental health screening on a computer tablet; those in the control group will undergo the usual process (meet with nurse, complete a paper-based screen). All women will meet with a nurse after the screening to discuss results. All women will complete a questionnaire within one week of the screening to answer questions about the screening experience. WHY IT IS IMPORTANT.Mental health screening can increase access to early intervention. Early treatment may prevent poor child development and child mental health problems that can result if maternal mental health problems are untreated.