About the Project
Dr. Shana Johnston knows first-hand what it feels like to suffer from post-partum depression and anxiety. When her daughter was three weeks old, she started having trouble sleeping and feeling anxious. With a colicky baby to look after, this progressed quickly to the point she felt she was not coping at all and when her baby was 2 months old she finally admitted to her doctor that she needed help. As part of her treatment plan, her doctor encouraged her to join a peer-facilitated support group offered through the Pacific Post Partum Support Society (PPPSS), a non-profit based in Vancouver. She was fortunate to be able to join a group within a couple of weeks of reaching out and was able to experience first-hand the magic of healing together in community. The wonderful facilitators at PPPSS created a safe place for her and the others in the group to be vulnerable, to learn from each other through sharing their challenges and to know that they weren’t alone in their struggles.
As a GP providing both family and maternity care to her patients, Dr. Johnston has seen women suffering from postpartum depression and anxiety and struggled to know where to send them for support. Prior to COVID, there were four public health nurse-facilitated groups being offered in Victoria, though the wait list was between 3-6 months to join. At the advent of COVID, these programs stopped, due to the redeployment of public health nurses. Women with post-partum depression and anxiety were left to try to find support through family and friends, or pay for private care through counsellors or psychiatrists.
To address this gap in service, Dr. Johnston teamed up with Heather Barnes, a local “peer” (person with lived experience of postpartum depression and anxiety) and collaborated with Clare Zeschky (Heather’s peer mentor) and Sheila Duffy (Director) from Pacific Post Partum Support Society to pilot a peer-facilitated group support program, offered virtually over the course of 12 weeks, with an optional 8 week extension at the request of the participants. This program offered support to 10 women recruited through a variety of primary and maternity care providers, public health clinics, and the PPPSS Facebook page.
Drawing on funding and support from the South Island Medical Staff Association and the Physician Quality Improvement program, Dr. Johnston evaluated the program’s success. Participants’ perceived levels of support increased from 4.8/10 to 9.4/10 during the course of the program, while their perceived levels of isolation dropped from 7.7/10 to 2.6/10 over the same time period. Each participant completed the Edinburgh Post-Partum Depression Scale (EPDS), the standard measure for this condition, at the beginning and end of the program, and showed significant improvement: from an average of 16.6 at intake to 8.1 by the end of the full program. This represented an improvement of over 50%.
Dr. Johnston was recently awarded a Health System Redesign grant to support an ongoing partnership with Island Health to deliver this service in a sustainable way. Speaking about the program’s value, Dr. Johnston commented, “This is a very cost-effective way of providing care for people struggling with postpartum depression and anxiety. The peer facilitators are paid $20-25/hr which is a fraction of the cost of having a nurse, doctor, counsellor or psychiatrist run a similar program and has the added benefit of removing much of the power dynamic when offered by a peer”. She points to one study in the US which estimated the costs for untreated Post Partum Depression and Anxiety to be upwards of $32,000 USD per woman. “There is so much value in providing timely access to this service”, Dr. Johnston concludes, “and group support provides a safe place for participants to heal in community with others experiencing similar challenges”.
Dr. Johnston will be presenting the results of this project at Island Health’s upcoming Knowledge to Action month, on November 18th from 1-2pm.