Strengthening mental health capacity and service integration in primary postnatal care in Victoria

Postnatal mental health problems among women are associated with morbidity, reduced social participation, impaired infant development and family functioning, and constitute an Australian public health priority. Universal primary care health services (Maternal and Child Health and General Practice) are at the forefront of promotion, prevention and early intervention for postnatal mental health. However, they are under-resourced for these roles, and the two sectors are organisationally segregated. Health service reform to increase consistency of care and service integration, supporting a comprehensive stepped-care model of prevention, early intervention and treatment, is required. What Were We Thinking (WWWT) is an evidence-informed, effective, acceptable, psycho-educational model of postnatal care that addresses known but neglected risks for mental health at this phase of life. It is non-stigmatising, and facilitates clinician professional development, parent skill-building, and identification of and early intervention for mental health problems. DHHS has commissioned Rowe and Fisher to implement WWWT in the Latrobe Valley (2018-2020). The Flagship will leverage this project to bring implementation science experts and consumers together with key government, primary care and community health partners to translate and scale up successful implementation of the reform. The Theoretical Domains Framework will guide investigation of stakeholder perspectives about required modifications and how to achieve and measure change in barriers and enablers for implementation. The Flagship outcome will be rigorously-evaluated, practical, implementation tools, specifically for consumers, clinicians, and health services. The tools will support WWWT scale-up across Victoria, and will be readily transferrable to implementation of other complex interventions and health settings.