Improving access to psychosocial interventions for perinatal depression in low- and middle-income countries: lessons from the field

Int Rev Psychiatry. 2021 Feb-Mar;33(1-2):198-201. doi: 10.1080/09540261.2020.1772551. Epub 2020 Jun 9.

Abstract

Over 90% women with perinatal depression in low and middle-income countries do not receive treatment. Scale-up of evidence-based psychosocial interventions is a key challenge. We developed the Thinking Healthy Programme (THP), a psychosocial intervention that can be delivered by non-specialist providers such as community health workers in primary and secondary care settings. Our research showed that three out of 4 women with perinatal depression who received the programme recovered, and there were beneficial effects on infant outcomes. In over a decade since the original research, policy and practice uptake of the programme globally has been promising. We describe factors contributing to this: the programme is relatively inexpensive and culturally transferable; the intervention can be integrated with existing maternal and child health programmes; the programme is amenable to 'task-sharing' via peers, nurses, community health-workers and other frontline workers; cascaded models of training and supervision, and the use of technology for training and delivery provide exciting future avenues for scaled-up implementation. These innovations are relevant to the neglected field of public mental health, especially in the post COVID19 era when rates of anxiety and depression are likely to rise globally.

Keywords: Perinatal depression; Thinking Healthy Programme; global mental health; low- and middle-income countries; psychosocial interventions.

MeSH terms

  • COVID-19
  • Depression / psychology*
  • Depression / therapy*
  • Developing Countries*
  • Female
  • Humans
  • Infant
  • Pregnancy
  • Psychosocial Intervention*