Mental health screening with a culturally appropriate tool

Health professionals and Aboriginal women in north-west Western Australia (WA) are using a holistic and culturally appropriate perinatal mental health screening tool known as the Kimberley Mum’s Mood Scale (KMMS).

The KMMS is helping health professionals in the region to better understand a perinatal woman’s context and what protective factors exist for her. The tool inductively builds a profile of a woman that explores her strengths and resiliency alongside her perinatal mental health risks.

The tool has been co-designed and validated with Aboriginal women and their health professionals. Since 2018, a study implementing the KMMS into routine primary healthcare practice has been supported by Kimberley Aboriginal Medical Services (KAMS); WA Country Health Service, Kimberley; and the Rural Clinical School of Western Australia (RCSWA).

Bardi Jawi woman Erica Spry works as a RCSWA research fellow and KAMS research officer. She explains why the KMMS has been embraced by her community and could be adopted by other First Nations peoples across Australia:

‘The KMMS comes from Aboriginal people’s common cultural practise of storytelling, listening, yarning and genuinely connecting with a woman to learn her strengths and challenges. It is the yarning that connects the woman and the health professional and builds the relationship.

‘For many remote Aboriginal women, that conversation with the midwife or Aboriginal health worker/practitioner may be the first time they have ever heard of perinatal depression. It might be the first time someone has checked in with them using this term and sat down to yarn about what it means.

‘Yarning through the KMMS can help the mother to realise that she has a lot of good happening in her life, and that she is not alone if she does experience feelings of anxiety and/or depression during her pregnancy. The KMMS creates a way for her to have that conversation with the clinic staff and for her to share what she is going through. Women have reported that they finally feel heard, seen and supported, and not just treated like a patient or number as they work through the KMMS.

‘What sets the KMMS apart from other screening tools is that it really explores a woman's self-efficacy and how she is navigating her risk factors. For example, a woman might share “I have a job, an extended family that help, but my finances have suffered because of COVID and I’m worried we might become homeless.” The midwife or Aboriginal health worker would help her explore support options (protective factors) such as her mother’s place, other family members or local/regional service providers. The clinician can also yarn with her and provide psychosocial support, brief interventions and referrals that connect her with other support services if there are other risks she is dealing with such as substance misuse and domestic violence. Sometimes women cannot readily identify their emotions, risks or protective factors. But, when you have a yarn with them, they learn how.

‘I believe the KMMS could potentially help other First Nations women because it offers a strength-based approach to mental health screening. We are evaluating the real-world performance of KMMS in the Kimberley, Pilbara and Far North Queensland and we welcome other regions to consider using the KMMS.

‘Our Elders are saying this holistic approach of yarning and providing gentle guidance has been needed for a long time. The world has moved on from the Edinburgh Postnatal Depression Scale and Aboriginal women deserve better.’

For free online access to KMMS training please visit: amsed.com.au/kmms-module