Just six weeks after the birth of her son, Mdm A was holding back her tears as she sat in the postnatal clinic at KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group, waiting to meet her obstetrician for her first postnatal visit.

While her husband, parents, in-laws and her friends all seemed overjoyed for her, she felt her world had crumbled around her since giving birth.

She wondered why she harboured thoughts of giving her baby away. But she was afraid to share these thoughts with her family, friends or doctor, lest they should criticise her.

She felt relieved when a case manager from the KKH Women’s Mental Wellness Service approached her about doing an emotional health screening. She was then able to unload her worries in private. As she was found to be a ‘high-scorer’, she was offered the option to see a psychiatrist, which she accepted.

With the support of her psychiatrist and her case manager, Mdm A has been coping better and is now beginning to enjoy her son.

The KKH Women’s Mental Wellness Service started its Postnatal Depression Intervention Programme (PNDIP) in April 2008 for women like Mdm A who are suffering from postnatal depression.

“With the prevalence of postnatal depression as high as 1 in 12 women in Singapore, KKH saw a need for early detection of this mental illness,” says Dr Theresa Lee, Senior Consultant at the Department of Psychological Medicine, KK Women’s & Children’s Hospital (KKH), a member of the SingHealth group.

From April 2008 to March 2013, about 8210 women have been screened under PNDIP. Of these, 416 (5.1 per cent) were found to be at-risk (borderline scorers) while 513 (6.2 per cent) were high scorers. These women were offered the option of receiving psychiatric care or counselling by their case managers.

Participants satisfied with PNDIP

90 per cent of the women who have participated in the programme have expressed satisfaction with the screening phase, and 100 per cent have expressed satisfaction with the intervention phase.

The outcomes have been very encouraging based on the improved scores on various depression assessment tools, such as the Edinburgh Postnatal Depression Scale (EPDS), Global Assessment of Functioning (GAF) and Euroqol health quality of life scores (QOL).

Screening and intervention phases of PNDIP

The KKH Postnatal Depression Intervention Programme (PNDIP) consists of two phases:

Screening phase: Women returning for a postnatal review at selected KKH clinics are assessed for postpartum mental illness and provided with appropriate care plans.

Intervention phase: Women at risk benefit from counselling support and phone follow-up care. As needed, the high-scorers can receive the help of a multidisciplinary team, along with support group intervention.

How can you tell if you have postnatal depression?

The following symptoms of postpartum depression can occur within the first three to six months after delivery, says Dr Lee:

  • Poor sleep and appetite, and loss of energy
  • Negative thoughts towards the baby or self
  • Low mood

PNDIP is available to non-KKH mothers too!

Although the Postnatal Depression Intervention Programme (PNDIP) focuses on the women who deliver at KKH, it is open to non-KKH patients too. It has provided care for 156 non-KKH patients since it began in April 2008, to March 2013.

The Women’s Mental Wellness Service at KK Women’s and Children’s Hospital (KKH) is dedicated to providing comprehensive evaluation and ongoing care to women who suffer from a spectrum of psychiatric disorders, and improving the lives of these women.

Ref: R14