Il progetto BLUES: implementare pratiche innovative nelle attività di screening e di home visiting rivolte alle donne con depressione perinatale

Introduction Perinatal depression is frequent (1 woman out of 10 during the perinatal period), nonetheless to this day the screening is incomplete and the treatment gap is high. Materials and methods The BLUES project was financed by the Italian Ministry of Health and implemented in 10 Local Health Units of Lombardy Region. It had the goals of improving screening and implementing home visiting for women with perinatal depression. As far as the first goal, a smartphone app searchable by authorized professionals has been developed for transmitting screening tools (Edinburgh Postnatal Depression Scale - EPDS - and Whooley questions) to a cloud database; the app was also connected to a free website informing on mental health during the perinatal period. As far as the second goal, a home visiting programme was implemented according to the WHO Thinking Healthy method. A total of 110 professionals (most midwives), working in the family care centers, attended a structured training course in the Thinking Healthy approach and then applied the intervention to women during the perinatal period. The effectiveness and feasibility of the intervention were assessed at its completion (pre-post comparisons). Results The smartphone app and the related website were successfully activated in family care centers in the Province of Lecco (Lombardy, Italy). 39 women responding to selection criteria (EPDS 10 and a diagnosis of depression) were recruited for the home visiting intervention: 31 of them have completed the Thinking Healthy program. A clinically significant reduction of the EPDS scores was assessed in 80% of the women with moderate depressive symptoms (EPDS score ≥ 12). Both women and professionals evaluated the intervention useful and acceptable. Conclusions The BLUES project improved the screening using e-tools and implemented home visiting following the Thinking Healthy method. The process of task shifting from mental health sector to midwives was successful, while professionals met difficulties in balancing home visiting activities and routine activities.