Approach to perinatal mental health and child abuse prevention in Japanese prefectural health centers

Kafumi Sugishita, Kayoko Kurihara, Shiho Murayama, Kiyoko Kamibeppu

Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

DOI: 10.4236/health.2013.54097                

Abstract

The aim of this study was to conduct a nationwide survey in Japan of prefectural health centers, which were responsible for providing guidance to municipalities. The survey was performed in order to clarify the following issues: 1) the current level of support provided by prefectural centers for pre-and post-natal mental health; 2) the structures in place for providing consultation services for an “unwanted pregnancy” and the support available for high-risk cases; and 3) the advice available on postpartum maternal psychological screening, and interpretation of results of such screening. Questionnaires were sent by post to 394 prefectural health centers, of which 277 (70.3%) responded. A total of 32% of prefectural health centers confirmed that they had offered support to high-risk cases during pregnancy, and 72% had offered support post-partum. Regarding offering support to high-risk mothers, those prefectural health centers that did provide consultation services (n = 59) reported providing introductions and information about available facilities (P < 0.001) and conducting case conferences (P < 0.002). This was significantly different than prefectural health centers that did not provide consultation services (n = 198). At the prefectural health centers that “follow up on” the results of the mental health screening, psychiatry consultations were reported twice as often as the prefectural health centers that did “not follow up on” the results of mental health screening. These findings indicate that childcare support systems for postpartum mental health and the prevention of child abuse were established. However, the lack of prenatal health and support systems for the prenatal period remains an issue.

Keywords

Child Abuse Prevention; Perinatal Mental Health; Prefectural Health Centers; Municipal Health Centers

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Ministry of Health, Labor and Welfare (2007) An intermediate evaluation of the plan. Journal of Health and Welfare Statistics, 94, Tokyo. http://www.mhlw.go.jp/shingi/2006/03/s0316-4.html
[2]	Ministry of Health, Labor and Welfare (2007) The verification results of the death caused by child abuse cases. http://www.mhlw.go.jp/houdou/2007/06/dl/h0622-5b.pdf
[3]	Olds, D.L., Henderson, C.R., Chamberlin Jr., R., et al. (1986) Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78, 65-78.
[4]	Olds, D.L., Eckenrode, J., Henderson, C.R., et al. (1997) Long-term effect of home visitation on maternal life course and child abuse and neglect: 15-year follow-up of randomized trial. Journal of the American Medical Association, 278, 637-643. doi:10.1001/jama.1997.03550080047038
[5]	Donelan, M.N., Eckenrode, J. and Olds, D.L. (2009) Home visiting for the prevention of child maltreatment: Lessons learned during the past 20 years. Pediatrics Clinics of North America, 56, 389-403. doi:10.1016/j.pcl.2009.01.002
[6]	MacMillan, H.L., Thomas, B.H., Jamieson, E., et al. (2005) Effectiveness of home visitation by public-health nurses in prevention of the recurrence of child physical abuse and neglect: A controlled trial. Lancet, 365, 1786-1793. doi:10.1016/50140-6736(05)66388-X
[7]	Krugman, S.D., Lane, W.G. and Walsh, C.M. (2007) Update on child abuse prevention. General Pediatrics, 19, 711-718. doi:10.1097/MOP.0b013e3282f1c7e1
[8]	Kitamura, T., Shima, S., Sugawara, M., et al. (1996) Clinical and psychosocial correlates of antenatal depression: A review. Psychotherapy and Psychosomatics, 65, 117- 123. doi: 10.1159/000289062
[9]	Kitamura, T., Yoshida, K., Okano, T., et al. (2006) Multicenter prospective study of perinatal depression in Japan: Incidence and correlates of antenatal and postnatal depression. Archives of Women’s Mental Health, 9, 121-130. doi:10.1007/s00737-006-0122-3
[10]	Honjyo, S., Arai, S., Kaneko, H., et al. (2003) Antenatal depression and maternal-fetal attachment. Psychopathology, 3, 304-311. doi:10:1159/000075189
[11]	Okamoto, R. (2009) Community child health care in Japan. Journal of Family Health Care, 19, 210-211.
[12]	Yamada, K. and Noda, J. (2002) A study on child abuse and neglect cared by public health nurse (PHN) of local health center: Based on nation wide survey. The Journal of Child Health, 61, 568-576.
[13]	Kogure, M., Hasegawa, K., Osawa, M., et al. (2005) Collaborations of public health care facilities for supporting a family with a premature baby. Gunmakenrituiroyo Tankidaigakukiyo, 12, 69-81.
[14]	Watanabe, Y. (2007) Perinatal medical care and child abuse prevention. Japanese Journal of Pediatrics, 60, 791-796.
[15]	Nakaita, I. (2002) Development of the action for child abuse prevention. The Journal of Public Health Practice, 66, 531-533.
[16]	Sato, A., Kitamiya, C., Lee, S.Y., et al. (2008) Circumstances and comparisons of child rearing burnout scales between neonatal mothers with and without home visit nursing. Japanese Journal of Public Health, 55, 318-325.
[17]	Ueno, M. and Yamada, K. (1997) The role of public health nurses in child abuse and neglect. Bulletin of Osaka Prefecture College of Nursing, 3, 15-25.
[18]	Ministry of Health, Labor and Welfare Statics Association (2007) Kokumin Eisei no Doukou. Ministry of Health, Labor and Welfare, 54, Tokyo.
[19]	Ministry of Health, Labor and Welfare Statics Association (2007) Kokumin Fukushi no Doukou. Ministry of Health, Labor and Welfare, 54, Tokyo.
[20]	Mother’s & Children’s Health Organization (2009) Maternal and child health statistics of Japan. Wagakuni no Boshi Hoken, Tokyo.
[21]	Mother’s & Children’s Health Organization (2007) Maternal and child health statistics of Japan. Boshihoken no Omonaru Tokei, Tokyo.
[22]	Ministry of Health, Labor and Welfare (2005) How to intervene the child abuse and neglect cases. Kodomo Gyakutai Taio no Tebiki, Tokyo.
[23]	Yamashita, H. and Yoshida, K. (2004) Investigation of community based preventive intervention using the self report questionnaires for mothers at risk for child abuse: Contribution of perinatal psychiatry to child abuse in infancy. Japanese Journal of Child Abuse and Neglect, 6, 218-231.
[24]	Cox, J.L., Holden, J.M. and Sagovsy, R. (1987) Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782-786. doi:10.1192/bjp.150.6.782
[25]	Yoshida, K., Yamashita, H., Conry, S., et al. (2012) A Japanese version of mother-to-infant bonding scale: Factor structure, longitudinal changes and links with maternal mood during the early postnatal period in Japanese mothers. Archives of Women’s Mental Health, 15, 343- 352. doi:10.1007/s00737-012-0291-1
[26]	Kamibeppu, K. (2008) Systems for perinatal mental health and child rearing. The Foundation for Children’s Future, Tokyo.
[27]	Olds, D.L. (2002) Prenatal and infancy home visiting by nurse: From randomized trials to community replication. Prevention Science, 3, 153-172. doi:10.1542/peds.110.3.486
[28]	Flynn, L., Budd, M. and Modelski, J. (2008) Enhancing resource utilization among pregnant adolescents. Public Health Nursing, 25, 140-148. doi:10.1111/ j.1525-1446.2008.00690.x.
[29]	Sato, T. (2008) Evaluation of a risk assessment scale for child abuse in the field of public health and development of systematic community public health activities for abuse prevention. Japanese Journal of Child Abuse and Neglect, 10, 66-74.