Ground-breaking program cuts post-natal mental disorders among women with new babies dramatically


In a world first, published today in BMJ Open, new Australian research from Monash University has shown that post-natal mental health problems can be reduced by up to two-thirds through an innovative program.

The program, called What Were We Thinking! (WWWT), was developed by the Jean Hailes Research Unit (JHRU) in the School of Public Health and Preventive Medicine.

JHRU director Professor Jane Fisher and Senior Research Fellow Dr Heather Rowe applied a new way of thinking to the prevention of postpartum common mental disorders. Rather than the traditional focus on a woman’s characteristics and health, this program focuses on the people nearest to her: her partner and her baby.

The WWWT program focuses on giving parents the knowledge and skills they need to manage two common problems that cause psychological distress: a baby with crying and sleeping difficulties and arguments about who does what at home.

"WWWT is so effective because of its simplicity and its relevance to every parent with a first baby. The messages are consistent across the program," Professor Fisher said.

WWWT has three components. About six weeks after giving birth, women, their partners and their babies attend a one-day seminar with other local families. A Maternal and Child Health (MCH) nurse trained in the WWWT program guides them through topics such as how to soothe and settle the baby, how to negotiate the division of household tasks fairly and how to encourage and not criticise each other. The parents take printed materials home to review. At later visits to nursing centres to check the baby’s health, the MCH nurse asks how parents are using the WWWT skills and helps them to problem-solve.

This is the world’s first cluster randomised controlled trial of this program (funded by the National Health and Medical Research Council) – among the women who completed the full WWWT program, depression and anxiety were reduced by more than 60 per cent.

"The program is readily integrated into local maternal and child health nursing services at low cost. Nurses require only two days of training to learn how to use the program," Professor Fisher said.

“This is a modest investment for the major benefit of preventing mental health problems among the tens of thousands of women who give birth to a first baby each year," Dr Rowe said.

A free blog and app linked to the WWWT program have been developed with partner organisation Jean Hailes for Women’s Health.

"One out of eight new mothers will experience a mental health problem, including anxiety and depression," Janet Michelmore, Executive Director at Jean Hailes for Women’s Health said.

"The WWWT program enhances current essential primary care services and can be integrated seamlessly. WWWT, including the blog and app, offers simple and supportive solutions to the common challenges new parents face."

About Professor Jane Fisher

Professor Jane Fisher is Director of the Jean Hailes Research Unit. She is an academic clinical psychologist with longstanding interests in the links between women’s reproductive health and mental health. She has completed major epidemiological studies in clinical and community settings in Australia and Vietnam and nationally- funded intervention trials. In 2014 she was elected, in a worldwide ballot, President (2016-2018) of the Marcé Society for perinatal mental health. She Chairs the NHMRC Expert Committee on Mental Health and Parenting.

About Dr Heather Rowe

Dr Heather Rowe is a Senior Research Fellow at the Jean Hailes Research Unit. She is a health scientist expert in health promotion and perinatal mental health. She is Secretary-general of the International Society for Psychosomatic Obstetrics and Gynaecology.

About Jean Hailes for Women's Health

Jean Hailes for Women’s Health is a not-for-profit organisation committed to improving women’s knowledge and understanding of complex health issues. Jean Hailes has a unique model, comprising three fully integrated business units: The Medical Centre; Translation, Education & Communication Unit and The Jean Hailes Research Unit, which is a formal partnership with Monash University.

About the School of Public Health and Preventive Medicine at Monash University

The School of Public Health and Preventive Medicine at Monash University is the most prominent school of public health in Australia and among the most highly ranked worldwide. Its research focuses on prevention of disease and disability through a commitment to education, innovation, leadership, and research. Women’s health is a major research focus.

Media contact

For interviews and case studies, please contact Janelle Carrigan at Jean Hailes for Women’s Health at Janelle.carrigan@jeanhailes.org.au or 0409 939 920

BMJ Open study details

Fisher J, Rowe H, Wynter K, Tran T, Lorgelly P, Amir L, Proimos J, Ranasinha S, Hiscock H, Bayer J, Cann W. A gender-informed, psychoeducational program for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial. BMJ Open, doi:10.1136/bmjopen-2015-009396

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