The Perinatal Wellbeing Service (PWS) model is a nurse-led, client-centred model for perinatal mental health, developed and provided by mental health nurses. It was implemented in 2015 to target service gaps for pregnant and postnatal women experiencing perinatal mental health concerns in Logan and Beaudesert, and was extended to Redlands in 2018. The service provides non-urgent, voluntary services over one to six community-based appointments with experienced perinatal mental health nurses while supporting and educating GPs, midwives, child health nurses and obstetricians to provide evidence based care. The PWS also includes a nurse practitioner who can prescribe antidepressant medication using a risk benefit assessment or, where women are linked with a GP, support GPs to prescribe using contemporary evidence based recommendations.
The PWS is voluntary and focuses on encouraging self-determination around health and wellbeing goals. To aid access, the referral process is simple and accepts referrals from women or their families with consent as well as from a variety of professionals. A range of communication means helps with ease of access including phone calls, text messages, emails and postal letters. Referrers and GPs are kept well informed by letters about the outcome of the referrals. Women are offered a choice of appointment location options that are convenient and friendly and include community health, NGOs, child health, GP practices, local kindergarten, one of the many maternity group practice (MGP) hubs or at the hospital around the time of their hospital antenatal visits if preferred. The co-location of clinics within key NGOs, (including the Eagleby Family Centre, the Family Centre at Woodridge, Kingston East Neighbourhood Centre and Redland Community Centre) provides a less stigmatising environment and a soft entry point for new referrals. Furthermore, women and families can directly access a variety of other psychosocial and health supports.
Treatment plans are developed in partnership with the woman and her supports and, with consent, shared with relevant stakeholders. While the partnership approach to care is centred on the perinatal woman and her family it also refers to shared care with other involved health providers such as GPs, midwives, obstetricians, child health nurses and NGOs.
In addition, the PWS has a strong focus on working closely with NGO’s around perinatal mental health promotion and community education, prevention and early intervention. A key annual event hosted by the PWS is for the national perinatal anxiety and depression awareness (PANDA) week in November and involves a range of community agencies that are family focused. The team provides formal support and education to their GP, midwife, child health and other mental health partners, along with cross team collaboration and expertise to external case conferences such as the child safety meetings and high-risk maternity meetings at Logan and Redlands. The PWS clinicians are lead facilitators for the statewide 'Together in Mind' day program delivered collaboratively with child health and infant mental health clinicians.
The model offers the potential for replication in other areas where service gaps for perinatal women and families persist and resources remain scarce, with the research providing unique information on the role of the nurse practitioner within this specialty area. The success of the model has been presented at several conferences including the Australian College of Mental Health Nurses, Queensland Consultation Liaison Psychiatry Symposiums, the Australian College of Nurse Practitioners and Metro South Community Nurses symposiums, and was recently recognised as a finalist in the 2018 Queensland Health Awards for Excellence.