m-Health solutions for perinatal mental health: a systematic search and appraisal following the App Evaluation Model (Preprint)

BACKGROUND Currently, the screening of perinatal mental health symptoms is confined to maternity and primary care settings. Critically, the ever-increasing pressure on healthcare systems has resulted in under-recognition of perinatal mental disorders. Digital mental health tools, such as applications (apps) could provide an option for accessible perinatal mental health screening and assessments. However, there is a lack of information regarding the availability and effectiveness of perinatal app options. OBJECTIVE To evaluate the current state of diagnostic and screening apps for perinatal mental health available on the Google Play store (Android) and Apple App store (iOS), and to review their features following the App Evaluation Model framework. METHODS A systematic review approach was used to identify perinatal mental health assessment apps on the Apple App store and Google Play store. 14 apps met inclusion criteria, were downloaded, and reviewed in a standardized manner using the App Evaluation Model framework. The framework comprised 107 questions allowing for a comprehensive assessment of app origin, functionality, engagement features, security, and clinical use. RESULTS The majority of apps were developed by for-profit companies (n=10), followed by private individuals (n=2), and trusted healthcare companies (n=2). Three apps were only available on Android devices, four were available only on iOS devices, and seven on both platforms. Approximately a third of apps (n=5) had been updated within the last 180 days. Most apps did not have enough reviews to display average ratings. Twelve apps offered the Edinburgh Postnatal Depression Scale (EPDS) in its original version or in rephrased versions. Additionally, one app included screening scales for anxiety, insomnia, and post-traumatic stress disorder. Engagement, input, and output features included reminder notifications, connection to therapists, and free writing features. Six apps offered psychoeducational information or references. Privacy policies were available for 11 of the 14 apps, with a median Flesch-Kincaid reading grade level of 12.3 One app claimed to be compliant with Health Insurance Portability and Accountability Act standards, two apps claimed to be General Data Protection Regulation compliant. Of the apps that could be accessed in full (n=10), all appeared to fulfil the claims stated in their description. Only one app referenced a relevant peer-reviewed study. All the apps provided a warning for use highlighting that the mental health assessment result should not be interpreted as a diagnosis nor as a substitute for medical care, hence all the apps were regarded as reference apps and not self-help tools. Only three apps allowed users to export or email their mental health test results. CONCLUSIONS These results support the view that there is space for designing and improving perinatal mental health applications. To this end, we recommend three areas of focus for app developers and clinicians looking to design apps for perinatal mental health assessment.

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Asylum Adjudication, Mental Health and Credibility Evaluation

Federal Law Review ◽

10.22145/flr.41.3.4 ◽

2013 ◽

Vol 41 (3) ◽

pp. 471-495 ◽

Cited By ~ 4

Author(s):

Jill Hunter ◽

Linda Pearson ◽

Mehera San Roque ◽

Zac Steel

Keyword(s):

Mental Health ◽

Health Assessment ◽

Poor Mental Health ◽

Decision Makers ◽

Psychological State ◽

Post Traumatic Stress ◽

Mental Health Assessment ◽

Expert Opinions ◽

Post Traumatic ◽

Answering Questions

This article examines the central role that credibility assessment plays in refugee determinations. It draws on the authors' own empirical study, Tales of the Unexpected, to display the complex ways in which applicants' poor mental health can affect their capacity to present a 'coherent and plausible‘ account of their experiences. The authors then explore the significant issues arising from the tendency revealed in the Tales study for decision makers to dismiss expert opinions expressed in reports tendered by applicants from psychologists specialising in cross-cultural mental health assessment. For example, consider the decision maker who observed that [The] psychologist reported that the Applicant was suffering from post-traumatic stress disorder and depression and that this psychological state was likely to affect his ability to answer questions at an RRT hearing …. [Nevertheless] [Mr S] did not display any difficulty in understanding or answering questions. … He [appeared] alert, engaged, and is clearly an intelligent man. I do not accept that he had any difficulty in understanding proceedings or answering questions.5

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Assessing the Mental Health of Fathers, Other Co-parents, and Partners in the Perinatal Period: Mixed Methods Evidence Synthesis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.585479 ◽

2021 ◽

Vol 11 ◽

Author(s):

Zoe Darwin ◽

Jill Domoney ◽

Jane Iles ◽

Florence Bristow ◽

Jasmine Siew ◽

...

Keyword(s):

Mental Health ◽

Health Professionals ◽

Evidence Synthesis ◽

Health Assessment ◽

Depression Scale ◽

Perinatal Period ◽

Service Level ◽

Screening Tools ◽

Perinatal Mental Health ◽

Published Evidence

Introduction: Five to 10 percentage of fathers experience perinatal depression and 5–15% experience perinatal anxiety, with rates increasing when mothers are also experiencing perinatal mental health disorders. Perinatal mental illness in either parent contributes to adverse child and family outcomes. While there are increasing calls to assess the mental health of both parents, universal services (e.g., maternity) and specialist perinatal mental health services usually focus on the mother (i.e., the gestational parent). The aim of this review was to identify and synthesize evidence on the performance of mental health screening tools and the acceptability of mental health assessment, specifically in relation to fathers, other co-parents and partners in the perinatal period.Methods: A systematic search was conducted using electronic databases (MEDLINE, PsycINFO, Maternity, and Infant Care Database and CINAHL). Articles were eligible if they included expectant or new partners, regardless of the partner's gender or relationship status. Accuracy was determined by comparison of screening tool with diagnostic interview. Acceptability was predominantly assessed through parents' and health professionals' perspectives. Narrative synthesis was applied to all elements of the review, with thematic analysis applied to the acceptability studies.Results: Seven accuracy studies and 20 acceptability studies were included. The review identified that existing evidence focuses on resident fathers and assessing depression in universal settings. All accuracy studies assessed the Edinburgh Postnatal Depression Scale but with highly varied results. Evidence on acceptability in practice is limited to postnatal settings. Amongst both fathers and health professionals, views on assessment are mixed. Identified challenges were categorized at the individual-, practitioner- and service-level. These include: gendered perspectives on mental health; the potential to compromise support offered to mothers; practitioners' knowledge, skills, and confidence; service culture and remit; time pressures; opportunity for contact; and the need for tools, training, supervision and onward referral routes.Conclusion: There is a paucity of published evidence on assessing the mental health of fathers, co-mothers, step-parents and other partners in the perinatal period. Whilst practitioners need to be responsive to mental health needs, further research is needed with stakeholders in a range of practice settings, with attention to ethical and practical considerations, to inform the implementation of evidence-based assessment.

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Proof-of-concept support for the development and implementation of a digital assessment for perinatal mental health: a mixed methods study (Preprint)

10.2196/preprints.27132 ◽

2021 ◽

Author(s):

Nayra Anna Martin-Key ◽

Benedetta Spadaro ◽

Thea Sofie Schei ◽

Sabine Bahn

Keyword(s):

Mental Health ◽

Health Assessment ◽

Mental Healthcare ◽

Perinatal Period ◽

Perinatal Mental Health ◽

Health Concerns ◽

Mental Health Assessment ◽

Digital Assessment ◽

Mental Health Concerns ◽

The Uk

BACKGROUND Perinatal mental health symptoms commonly remain underdiagnosed and undertreated in maternity care settings in the UK, with outbreaks of disease, like the coronavirus (COVID-19) pandemic, further disrupting access to adequate mental health support. Digital technologies may offer an innovative way to support the mental health needs of women and their families throughout the perinatal period, as well as assist midwives in the recognition of perinatal mental health concerns. However, little is known about the acceptability and perceived benefits and barriers to using such technologies. OBJECTIVE To conduct a mixed methods evaluation of the current state of perinatal mental healthcare provision in the UK, as well as users’ (women and partners) and midwives’ interest in using a digital mental health assessment throughout the perinatal period. METHODS Eight hundred and twenty-nine women, 103 partners, and 90 midwives participated in the study, which entailed completing an online survey. Quantitative data were explored using descriptive statistics. Open-ended response data were first investigated using thematic analysis. Resultant themes were then mapped onto the components of the Capability, Opportunity, and Motivation Model of Behavior (COM-B model) and summarized using descriptive statistics. RESULTS The provision of adequate perinatal mental healthcare support was limited, with experiences varying significantly across respondents. There was a strong interest in using a digital mental health assessment to screen, diagnose, and triage perinatal mental health concerns, particularly among women and midwives. The digital assessment was seen to be well placed within maternity healthcare settings, with in-person only and blended care (i.e., in-person and remote support) approaches being preferred by women and partners in the event of further care being advised. Identified benefits and barriers mainly related to physical opportunity (e.g., accessibility), psychological capability (e.g., cognitive skills) and automatic motivation (e.g., emotions). CONCLUSIONS This study provides proof-of-concept support for the development and implementation of a digital mental health assessment to inform clinical decision-making in the assessment of perinatal mental health concerns in the UK.

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