Western Australian women will be the first to benefit from a new resource developed to detect perinatal mental illness in women from CALD backgrounds.

The resource, ‘Using the Edinburgh Postnatal Depression Scale (EPDS): Translated into languages other than English’, is the first of its kind in Australia and possibly the world. It was launched in Western Australia on the 13 March 2007.

It contains 36 translations of the Edinburgh Postnatal Depression Scale (EPDS), a 10-item self-report questionnaire used to identify mothers who may have depression or anxiety.

Women throughout the world commonly experience depression and/r anxiety during and after pregnancy. This is referred to as perinatal mental illness. Studies consistently show that between 10 and 20 per ent of mothers experience perinatal mental illness, yet many are not diagnosed and treated.

The causes of perinatal mental illness are not well known. However, a number of factors have consistently been found to increase the risk of depression and anxiety.  These include a lack of social support, stress and a history of mental illness.

Women from CALD backgrounds have also been found to be at higher risk, especially if they have migrated to English-speaking countries. This may be due to the stress associated with migrating and the absence of social support within a new community.

The EPDS is a screening measure commonly used throughout Australia to identify women who may have this illness. The questionnaire includes items that reflect symptoms of depression and anxiety, ranging from feeling sad and anxious to thoughts of self-harming.

Many studies in Australia and overseas have shown that EPDS screening is better than clinical judgement alone.
 
The EPDS was originally developed in English and has since been translated and validated in many different languages. Prior to this resource, access to EPDS translations has been limited. This has forced CALD women, living in Western Australia, to rely on poor-quality translated materials and in some instances not be screened at all.

The Department of Health of Western Australia, namely the Child and Adolescent health Service and State Perinatal Mental Health Reference Group

The resource contains two parts for validated or non-validated EPDS translations. Part one of the resource contains 18 translated EPDS versions, which have been validated in a variety of populations and at varying times during the perinatal period. All 18 validated EPDS versions were translated using certain criteria for cross-cultural equivalence. These versions were then used in research and compared to reference measures of depression or anxiety.

For each language, the resource contains recommended cut-off points; a list of countries where the language is spoken; and a summary of validation studies.

There are also ‘notes’ for each translation containing guidelines on cultural issues and specific information to help health practitioners use the translations effectively.

All translations were checked for accuracy and revised in Australia by authorised translators. All of these EPDS translations are now presented in a clean, standardised format.

Part two of the resource includes another 18 non-English EPDS versions that are direct translations of the original EPDS. Registered translators translated all of these versions. However, these were not developed against equivalent criteria or validated in research. These additional translations were commissioned to ensure that the resource included an EPDS for most CALD women having babies in Western Australia.

The new resource will help health professionals to identify CALD women who may have a mental illness during pregnancy or after delivery. These women will then have access to assessment, support, treatment and services to promote their health and wellbeing and that of their infant and family.

The Royal College of Psychiatrists in London granted special permission for the Department of Health Western Australia to develop these translations in electronic and paper format. A copy of the resource has been sent to the college and has been formally acknowledged.

Copies of the full resource will be available at most community health and perinatal mental health service sites in Western Australia. The Department of Health is also working towards making the translated EPDS versions available via a secure on-line site.