By Al Beeber on June 26, 2021.
Funding has been renewed for an Alberta initiative that supports mental health care for women and their families.
The initiative is a joint project between the Royal Alexandra Hospital in Edmonton and the University of Calgary Faculty of Nursing.
The original focus of the pan-provincial research chair was perinatal mental health and looked at the long-term health of pregnant and postpartum women.
The five-year $1 million funding just announced will allow the initiative to expand to cover all aspects of women’s lives and build on the launch of the HOPE digital mental health platform, created by Dr. Dawn Kingston and her team at the Royal Alexandra Hospital.
Right now the platform is still in a research stage and has already assisted 3,500 women but in September it will become fully accessible to women across Alberta and Canada.
Many women struggle with mental health issues during and after pregnancy and the isolation brought about by COVID-19 restrictions has amplified those problems, Kingston suggested in a telephone interview from Edmonton this week.
And mental health struggles have nothing to do with “hormones,” said Kingston.
“Hormones are a myth, that’s the reason women don’t reach out. They think it will resolve,” the doctor said.
The platform will allow women to seek help on their own anonymously without the stigma attached to mental health struggles. A telephone life coach will be available to provide help, if needed, for women to get more resources.
“Women like that; they want to manage their own emotional well-being on their own terms. This gives them a starting point,” said Kingston.
Immigrant women, especially, feel the need to be anonymous is important due to cultural pressures, she said.
With the platform, there will be immediate access with no wait times, no barriers and accessibility to all areas of the province.
Mental health issues normally affect about one in four women, said Kingston, and COVID has elevated those figures.
“A couple of studies that just came out show higher than what we would normally expect.
“We see about one in four women have depression or anxiety. That would be typical. Postpartum depression they would say 13 per cent” but COVID has impacted that.
“The numbers are higher. What I haven’t seen is a direct comparison of pregnancy to non-pregnant women so I can’t really say if it’s higher than average in the average population but is that an important number anyway?
“The important thing is anxiety and depression are creeping up in COVIDâ€¦another study out of Toronto saw this is across the pandemic,” she said.
“We are concerned about that and it will be interesting to see if those numbers come down again.”
Kingston said in her clinical research, isolation appears to be key to those numbers.
“Women are having babies in a very unnatural way. They’re having babies without family around, without close support nearby. They’re not having (baby) showers, and all of these things. It’s not just because these are celebratory in nature, I think they’re markers of transition to parenthood or motherhood.
“So without those kinds of markers of transition, then it’s just harder to adjust and make that leap, whether it’s to your first baby or a second child.”
She said there is also the extra burden of not having physical help around and trying to figure out what is normal and what isn’t.
“I think also what women do during the pandemic is they turn to social media and that is absolutely dangerous because it really puts the comparative piece in there. We know that women are comparing themselves to other women, happy babies, things like that.
“I think what it does is it digs women in a pit of shame and guilt and that’s what we see. . ..it’s the guilt and the shame women feel because they feel inadequate and when you put social media as the comparator, it’s not hard for any of us to feel inadequate,” she said.
“Mental health problems in pregnancy and postpartum are the most common complication that we don’t screen for or routinely treat.
“And we don’t do that because many practitioners don’t know how to screen and treat women in pregnancy for mental health problems. They’re nervous about it, they’re nervous about their knowledge and their connections to the mental health world,” Kingston said.
She said women feel “stigma, embarrassment, guilt and shame” about not being happy during pregnancy or after and “they don’t fully understand what’s normal or not. They think hormones rage” and thatÂ is the reason for their mental health issues, she said.
“So they don’t reach out for help because they just aren’t sure whether its normal or not. Women don’t tell and providers don’t ask. We’re in this stuck thing and the platform was meant to get out of that so that we could have routine mental health streaming in pregnancy and postpartum and treatment could be offered easily.
“We wanted to overcome the barriers that we currently see.”
She said shifting the health system would take 25 years and many financial resources but the platform can provide that shift quickly and cost-effectively.
“It’s a single, virtual point of care where it’s easy for a family doctor, midwife or obstetrician to simply give a link and once women had that link it was like a door opened to a mental health care system where they could have screening so they could know whether or not they were struggling. They could have online therapy that was easy to get to without cost and they could have a telephone coach to touch base at any point.”
Kingston said the renewal of the chair “will allow us now to take that to all women so even beyond the pregnancy, postpartum period.. .part of that is really driven by the fact that five out of seven women who had a mental health problem in pregnancy or postpartum will have it years later because we don’t catch it.
“Then women get busy, they put their own needs on the back burner, that kind of thing. They don’t know whether they’re struggling from anxiety or depression.
“The current evidence tells us this isn’t about hormones; this is not why women get depressed and anxious in pregnancy and postpartum.
“It has little to do with hormones and everything to do with things that actually we can have some management over.”
She said the top four risk factors in general include:
1) depression or anxiety previously.
2) a lot of stress in the previous year.
3) lack of social support.
4) partner conflict.
Women wanting to be part of the platform while it’s still in the research stage can get hold of Kingston through Royal Alexandra communications officer Kirby Zdrill by email at KZdrill@royalalex.org or by calling 780-735-6549.
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