Description: The Perinatal Mental Health Project (PMHP) was established in September 2002 and operates out of the Maternity Hospital in Mowbray. It was started to deal with post-natal depression, particularly prevalent in women in informal settlements. This depression has been shown to have very negative effects on child development. Pregnant women who are HIV positive are particularly vulnerable to mental health problems during pregnancy. The PMHP provides a counselling service for pregnant and postpartum women at the site that they receive obstetric care. With the help of multi-lingual mental health screening questionnaires, midwives are able to detect possible mental health problems in pregnant or postpartum women and provide counselling. The project also provides training and resources for perinatal mental health at all maternity units in Cape Town; creates awareness about mental health distress through a readily available multi-lingual pamphlet; and provides a platform for research into disciplines concerning perinatal health. The project has involved a wide range of medical staff, community organisations and other civil society organisations (e.g. NGOs). The PMHP has been funded by the provincial department of health, the EU Lilly Foundation and the Winnicott Foundation.
Innovation: The PMHP has provided a specific service to compliment existing maternity health services. It has created positive awareness about this form of mental health, which still has stigmatisations attached to it. It has provided a valuable service to many women who previously were not treated or did not know about it.
Effectiveness: During the first two and half years of the pilot project, 1700 were screened and about 300 women were counselled. Staff and perinatal mental health clients alike gave positive feedback about the service. A quantifiable evaluation has not been conducted as yet but funds are being sought to do this and thereby thoroughly review the service. The PMHP has received commendations from the WTO and the World Federation for Mental Health.
Poverty Impact: As stated above a quantifiable evaluation has not yet been conducted but gauging from the positive response, the project has in all likelihood contributed to preventing further mental health problems, thereby helping the recipients of the counselling and their children.
Sustainability: The PMHP currently receives a lot of help from volunteers and health workers contributing time on top of their other jobs and responsibilities. Certain donations are received on an ad hoc basis, while the provincial department of health contributes the majority of the funding (90%). In order for this programme to remain sustainable, the government will have to continue to contribute larger amounts of money in order to maintain permanent experienced staff. Private sector donations should also be sought and in this regard the project is looking to be registered as an NPO in order to attract this funding.
Replication: One case of replication is already being carried out at a site identified in Hanover Park. The PMHP is most definitely a replicable programme, satisfying a demand in the mental health sector. Sufficient funding and the enthusiasm from communities and health workers are essential in potential replication cases.