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Table 1 Psychosocial assessment and questions
| Variables (Risk factors) | Suggested format for psychosocial assessment questions |
|---|---|
| I. Lack of support | 1. Will you be able to get practical support with your baby? |
| 2. Do you have someone you are able to talk to about your feelings or worries? | |
| II. Recent major stressors in the last 12 months. | 3. Have you had any major stressors, changes or losses recently (i.e., in the last 12 months) such as, financial problems, someone close to you dying, or any other serious worries? |
| III. Low self-esteem (including lack of self-confidence, high anxiety and perfectionist traits) | 4. Generally, do you consider yourself a confident person? |
| 5. Does it worry you a lot if things get messy or out of place? | |
| IV. History of anxiety, depression or other mental health problems | 6a. Have you ever felt anxious, miserable, worried or depressed for more than a couple of weeks? |
| 6b. If so, did it seriously interfere with your work and your relationships with friends and family? | |
| 7. Are you currently receiving, or have you in the past received treatment for any emotional problems? | |
| V. Couple’s Relationship Problems or Dysfunction (if applicable) | 8. How would you describe your relationship with your partner? |
| 9. a) Antenatal: What do you think your relationship will be like after the birth? | |
| OR | |
| b) Postnatal (in Community Health Setting): Has your relationship changed since having the baby? | |
| VI. Adverse childhood experiences | 10. Now that you are having a child of your own, you may think more about your own childhood and what it was like. As a child were you hurt or abused in any way (physically, emotionally, sexually)? |
| VII. Domestic violence (DV) Questions must be asked only when the woman can be interviewed away from partner or family member over the age of 3 years. Staff must undergo training in screening for domestic violence before administering questions | 11. Within the last year have you been hit, slapped, or hurt in other ways by your partner or ex-partner? |
| 12. Are you frightened of your partner or ex-partner? (If the response to questions 11 and 12 is “No” then offer the DV information card and omit questions 13–18) | |
| 13. Are you safe here at home?/to go home when you leave here? | |
| 14. Has your child/children been hurt or witnessed violence? | |
| 15. Who is/are your children with now? | |
| 16. Are they safe? | |
| 17. Are you worried about your child/children’s safety? | |
| 18. Would you like assistance with this? | |
| Opportunity to disclose further | 19. Are there any other issues or worries you would like to mention? |
