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Mental Health Essay:Postpartum Depression in Aboriginal Australian Women

Question

Task: Write a mental health essay exploring a contemporary (current) practice topic that impacton the mental health and wellbeing of service users (consumers/clients/patients). Using a recovery focused approach you will consider strategies that could be used to work collaboratively with the person, their families and carers while respecting cultural and social sensitivities.

Answer

Introduction
The main concern of this mental health essay is postpartum depression which is a complex mixture of the physical, emotional as well as behavioral changes taking place in women after childbirth. This post-partum depression can be considered as the major form of depression among the women taking place after the four weeks of delivery (VanderKruik et al., 2017). According to the research conducted by Leason (2021), it has been found that as per the survey conducted among the indigenous women, the cases are considered to be 1.9 times higher in the case of the Indigenous Australian women of 25-40 years because of 3.3 times more stressful life events. On the other hand, according to the research carried out by WHO, on an average 10% of the pregnant women and 13% of the postpartum women experiences different types of mental disorder mostly depression and anxiety. Further, it has been found that this rate of prevalence is found to be higher in the low and middle-income countries with an average prevalence of 16% antenatally and 20% postnatal (VanderKruik et al., 2017). This essay will highlight the importance of post-partum depression from the global perspective as well as its significance for the nurses. Moreover, it will also discuss the importance of post-partum depression from the perspective of the service users, the carers, and the family. The strategies that are considered to be available to support the individual, their family, and carers along with the recovery-oriented approach used by the nurses to collaborate with the individual, their family, and the carers considering the social and the cultural needs will be discussed in the study.

Discussion
The estimates carried out by WHO have highlighted that the individuals of the reproductive age (15-49 years) accounted for 64 million of the global Disability Adjusted Life Years (DALY) between 2000 and 2012. However, with time, this burden of the disease has been increasing and thus it has been found that the behavioral and mental disorders increased from 5.9% to 7.3% of the DALY (Leason, 2021). The highest proportion of the DALY is generally found among women of reproductive years. These mental disorders are also linked with different types of maternal complications and the increased risk of adverse neonatal as well as developmental outcomes for the children. According to the clinicians, it has been found that the timeframe for post-partum depression should be extended to 6 months after the delivery based on the clinical experiences and depending on the episodes that are present not beyond 4 weeks (Leason, 2021). The different types of clinical features of post-partum depression include labile mood, dysphoric, agitation, elated, disorganized, and bizarre behavior. Moreover, the psychotic symptoms include delusion, hallucination as well as the mood-incongruent delusion that is linked to the self-harm of oneself and others.

Post-partum depression has been considered to be important for nursing because the nurses must go through the health history and identify the risk factors that are associated with it. However, this generally begins with the prenatal visit in the hospitals or the nursing centers and thus the nurses must use open-ended and active listening questions to determine the risk of the individuals (Kotz et al.,2021). On the other hand, it is the responsibility of the nurses to utilize the non-judgemental approach so that the patients can highlight the feelings. Even though motherhood and pregnancy are considered to be happy occasions, but the nurses are to be aware of the risk factors of the mothers linked with post-partum depression to avoid misfortunes. The nurses must also assist the mothers especially the aboriginal women in developing the proactive approach to care plan along with the co-operation of the carers and the family members of the patient (Owais et al., 2020). The nurses must also assist the patients suffering from post-partum depression to identify their support system and thus communicate with them to get relief from stress and anxiety. Further, it is the responsibility of the nurses to provide emotional support to the patients, instruct them about the prescribed medication and thus teach them to recognize suicidal ideation. All these aspects are possible only when the nurses carry out the improved level of communication with the patient through visiting them regularly during their stay in the hospital or making phone calls to them when they are at home (Eastwood et al., 2017). With the help of this communication, the nurses can also grow the personal level of attachment with the patients. As the nurses are considered to possess a strong sense of professional identity, it can be said that their cooperation is likely to help the Aboriginal women recover quickly. This availability of support services, medical security measures, as well as job autonomy, lays a positive influence on the job satisfaction of the nurses (Juntaruksa et al., 2017). Further, as the women suffering from post-partum depression can be considered to be sensitive, it is the responsibility of the nurses to lay positive reactions to assist the patient recover quickly. This positive working emotion will assist the nurses to work hard thereby improving the quality of care for the women.

Post-partum depression among Aboriginal women (24-40 years) is important for the family members, their carers, and the patients because in most cases they fail to identify the symptoms when the women generally get emotional after the first week of the child-birth. When such feelings continue to grow or get worse, the carers or the familymembers must approach the medical practitioner rather than keeping it untreated (Leason, 2021). Although it is found to occur in 1 mother out of 10 mothers, due to the carelessness of the family members or the carers of the Aboriginal, this problem is often left untreated. The family members or the carers of the women must not be disappointed, shocked, helpless, or frustrated and thus try their best to help in the recovery of the mother. There should be an improved level of communication between the carer, the patient, and the healthcare team to develop positive relationships and thus assist the women in the recovery from the firstepisodes of illness. Moreover, the family members must also try to listen to the concerns of the patients so that it becomes easier to provide support to the mothers at an appropriate time (Ogbo et al., 2018). The carers and the family members of the patients suffering from post-partum depression must try to keep track of the changes in the behavior of the women as well as the reaction to the medications. Further, if the family members or the carers observe any such changes, it is important to sit together with the healthcare professionals and thus discuss the issues. This will make it easier to carry out the diagnosis thereby maintaining confidentiality between the carers, the patients, the family members as well as healthcare professionals.

The strategies to support the women (25-40 years) suffering from post-partum depression is to assist them in building secure bonding with their children. This successful bonding will allow the children to be safe enough and thus it is likely to affect the growth of relationships in their life (Kiewa et al., 2021). On the other hand, women must be taught to take care of themselves after the delivery so that they avoid the chance of developing postpartum depression. The women must be provided with food rich in omega-3, take nap in between the day, sit in the sunlight and pamper themselves to make themselves feel relaxed and happy. There should also be sufficient steps taken by the carers or the family members to reintroduce exercise among the women after the delivery to combat post-partum depression (Smith et al., 2019). Carrying out gentle exercise after few days of delivery will assist the women to get rid of different types of complications related to cesarean delivery as well as postpartum depression. On the other hand, the carers and the family members of the women suffering from post-partum delivery must be allowed to develop a support network (Levis et al., 2021). This will assist in the development of positive social interaction as well as the emotional support that acts as the protective factors in the reduction of stress as well as dealing with difficulties (Carlin et al., 2021). However, in all cases, it is not important to grow an extensive network of close friends or family to benefit from the emotional and social support. There should be benefits through the development of mutual trust and friendship so that it becomes easier for the women to get rid of tensions, insecurities, and struggles. In extreme cases, the healthcare professionals might suggest anti-depressants to the women which are considered to be safe only when they consume them after the consultation with the doctors (Levis et al., 2021). However, in the case of the Aboriginal women (25-40 years), it might be difficult for both the carers and the family members to develop close relationships with the patient suffering from post-partum depression due to lack of attachment, understanding, love, care, and illiteracy among them.

The recovery-oriented approach includes the understanding of each individual differently to make support one’s own choice with respect and dignity. It is only through the recovery approach where the nurses can provide support to the women suffering from post-partum depression irrespective of the emotional experiences (Ogbo et al., 2019). The nurses must try to acknowledge varied types of individual differences among the women suffering from post-partum depression such as the beliefs, the culture, and the support networks. It is the responsibility of the nurses to be optimistic towards the patients suffering from post-partum depression depending on their strength, goals, and abilities. On the other hand, the nurses must co-operate with the mothers after their delivery and thus understand their mental health condition that differs from one individual to another (Hui et al., 2021). Moreover, the mothers after the delivery possess the right to choose the own path as well as their journey to wellness. This will make it easier to honor the diversity and thus practice the culturally safe and responsive aspects. The nurses have also tried to develop facilitation as well as the interconnection between health outcomes and community care (Levis et al., 2021). The process of recovery can be considered to be the long-term process of internal change that is generally processed across different stages of the delivery. Although different concerns are expressed among the nurses related to the varied principles linked with recoveries, such as autonomy and accountability, it also becomes easier to control the depression among the mothers associated with post-partum delivery. This will help the carers and the family members to combat different types of obstacles linked to recovery through the promotion of individualized nursing care (Leason, 2021). With the help of this approach, it also becomes easier to develop a moderate correlation between the quality of therapeutic relationship and the recovery orientation with an improved level of variability.

Conclusion
Thus, it can be said that the Aboriginal women suffering from post-partum depression must be motivated by the nurses to keep themselves safe and happy. Although, it has been found that the cases of post-partum depression among Aboriginal women can be considered to be increasing with time, so it is important to take long-term planning strategies to contribute to the management and the avoidance of such disorders. Therefore, it can be said that there should be adequate steps taken to carry out epidemiological research for the provision of the accurate and relevant prevalence of post-partum mental disorder among Aboriginal women in Australia. ?

References
Carlin, E., Seear, K. H., Ferrari, K., Spry, E., Atkinson, D., & Marley, J. V. (2021). Risk and resilience: a mixed methods investigation of Aboriginal Australian women’s perinatal mental health screening assessments. Social Psychiatry and Psychiatric Epidemiology, 56(4), 547-557. https://link.springer.com/article/10.1007/s00127-020-01986-7

Eastwood, J., Ogbo, F. A., Hendry, A., Noble, J., Page, A., & Early Years Research Group (EYRG). (2017). The impact of antenatal depression on perinatal outcomes in Australian women. PLoS One, 12(1), e0169907. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169907

Hui, A., Philips-Beck, W., Campbell, R., Sinclair, S., Kuzdak, C., Courchene, E., ... & Shen, G. X. (2021). Impact of remote prenatal education on program participation and breastfeeding of women in rural and remote Indigenous communities. EClinicalMedicine, 35, 100851. https://www.sciencedirect.com/science/article/pii/S2589537021001310

Juntaruksa, P., Prapawichar, P., &Kaewprom, C. (2017). Postpartum depression: A comparison of knowledge and attitude between the family members of postpartum women. ABAC Journal, 37(1), 134-144. http://www.assumptionjournal.au.edu/index.php/abacjournal/article/download/2780/1792

Kiewa, J., Meltzer-Brody, S., Milgrom, J., Bennett, E., Mackle, T., Guintivano, J., ... & Byrne, E. M. (2021). Lifetime Prevalence and Risk Factors for Perinatal Depression in a Large Cohort of Women with Depression. https://www.researchsquare.com/article/rs-362347/latest.pdf

Kotz, J., Marriott, R., & Reid, C. (2021). The EPDS and Australian Indigenous women: a systematic review of the literature. Women and Birth, 34(2), e128-e134. https://www.researchgate.net/profile/Jayne-Kotz/publication/339668001_The_EPDS_and_Australian_Indigenous_women_A_systematic_review_of_the_ literature/links/5e7192ef4585152cdbfa8284/The-EPDS-and-Australian-Indigenous-women- A-systematic-review-of-the-literature.pdf Leason, J. (2021). Indigenous Women’s Stress and Postpartum Depression: Discussions from the Canadian Maternity Experiences Survey and Indigenous Maternity Narratives. International Journal of Indigenous Health, 16(2). https://jps.library.utoronto.ca/index.php/ijih/article/download/33180/27367/

Leason, J. (2021). International Journal of Indigenous Health. Retrieved 12 May 2021, from https://jps.library.utoronto.ca/index.php/ijih/article/view/33180 Levis, B., Negeri, Z., Sun, Y., Benedetti, A., & Thombs, B. D. (2020). Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. bmj, 371. https://www.bmj.com/content/371/bmj.m4022.short

Ogbo, F. A., Eastwood, J., Hendry, A., Jalaludin, B., Agho, K. E., Barnett, B., & Page, A. (2018). Determinants of antenatal depression and postnatal depression in Australia. BMC psychiatry, 18(1), 1-11. https://link.springer.com/article/10.1186/s12888-018-1598-x

Ogbo, F. A., Ezeh, O. K., Khanlari, S., Naz, S., Senanayake, P., Ahmed, K. Y., ... & Eastwood, J. (2019). Determinants of exclusive breastfeeding cessation in the early postnatal period among culturally and linguistically diverse (CALD) Australian mothers. Nutrients, 11(7), 1611. https://www.mdpi.com/2072-6643/11/7/1611/pdf

Owais, S., Faltyn, M., Johnson, A. V., Gabel, C., Downey, B., Kates, N., & Van Lieshout, R. J. (2020). The perinatal mental health of Indigenous women: a systematic review and meta-analysis. The Canadian Journal of Psychiatry, 65(3), 149-163. https://journals.sagepub.com/doi/pdf/10.1177/0706743719877029

Smith, T., Gemmill, A. W., & Milgrom, J. (2019). Perinatal anxiety and depression: Awareness and attitudes in Australia. International Journal of Social Psychiatry, 65(5), 378-387.https://www.panda.org.au/images/uploads/Journal-article-IJSP-Community-Awareness.pdf

VanderKruik, R., Barreix, M., Chou, D., Allen, T., Say, L., & Cohen, L. S. (2017). The global prevalence of postpartum psychosis: a systematic review. BMC psychiatry, 17(1), 1-9. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1427-7?optIn=true

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