Know the Guidelines

Guidelines for screening for anxiety and depression vary among different professional associations. Below are the recommended screening guidelines for three main obstetric professional associations as well as the American Psychological Association:

American College of Nurse Midwives (ACNM):

  • Certified nurse-midwives (CNM) and certified midwives (CM) "should integrate prevention, universal screening, treatment, and/or referral for depression into the care they provide for women."
  • "Public health policies should be adopted that encourage universal screening, treatment, and/or referral for depression in women as a routine component" of primary care.[1]

American Academy of Family Physicians (AAFP):

  • Recommends screening when "staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up."
  • Staff-assisted depression care supports means "clinical staff that assist primary care clinician by providing some direct depression care and/or coordination, case management, or mental health treatment."[2]

American College of Obstetricians and Gynecologists (ACOG):

  • Screening should be strongly considered due to positive benefits for women and families, though ACOG does not have a current recommendation for universal screening.
  • Women with a positive screen require further evaluation and treatment.
  • Medical practices should have a referral process for mental health and psychiatric specialists if needed.
  • Women with current depression or a history of depression should be closely monitored during pregnancy.[3]

American Psychological Association (APA):

  • The U.S. Preventive Services Task Force is currently (spring 2014) collecting input to update its recommendations on depression screening in the adult population. In a recent written statement providing feedback on the USPSTF research plan, the APA stated that it supports universal depression screening in primary care for all adults.
  • Additionally, the APA encourages primary care practices to consider how to build relationships with mental health providers or incorporate mental health care into their practices so that appropriate supports are available.[4]

References:

  1. American College of Nurse-Midwives. (2013). Position statement – depression in women. Available at: http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000061/Depression%20in%20Women%20May%202013.pdf. Accessed April 22, 2014.
  2. American Academy of Family Physicians. (2010). Clinical recommendation: depression. Available at: http://www.aafp.org/patient-care/clinical-recommendations/all/depression.html. Accessed April 22, 2014
  3. The American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. (2010). Committee opinion number 453: Screening for depression during and after pregnancy. Available at: http://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co630.pdf?dmc=1&ts=20150817T2026073886. Accessed April 7, 2014.
  4. Corby-Edwards, A., on behalf of the American Psychological Association. (2014). Re: U.S. Preventive Services Task Force DRAFT Research Plan – Primary Care Screening for Depression in Adults. Available at: http://www.apa.org/about/gr/pi/news/2014/perinatal-depression-screening.pdf. Accessed June 16, 2014.