A positive screen and a frightened mother — perinatal mental health communication station

Communication station on postnatal depression with a positive self-harm item: sharing a screening result without stigma, completing a same-consultation risk assessment, agreeing a treatment plan that preserves breastfeeding, and communicating with a partner. Includes assessor timeline, marking domains, assessor key and fail criteria. Scored against the eight RANZCOG oral domains with emphasis on rapport, respect and communication.

Prompt

A 32-year-old woman attends her six-week postnatal check. She is a primary school teacher on maternity leave, G1 now P1 after an emergency caesarean for failure to progress. She completed the EPDS in the waiting room and scored 15, with a 1 on item 10. She is breastfeeding. When you enter the room she is tearful and says 'I'm sorry, I know I'm failing at this.' Her partner is in the corridor with the baby. You have 12 minutes to assess her, share the result, build a plan, and communicate safely with her and her partner.

Station brief

Format. Communication station, approximately 12 minutes, single candidate. The assessor plays the woman for the first nine minutes and the partner for the last three. The focus is on rapport, respect and communication alongside a clinically safe plan. The assessor feeds emotional cues and resistance.^[1]

Candidate instruction. Introduce yourself, share the screening result in a way that does not stigmatise her, complete a same-consultation risk assessment including item 10, agree a treatment plan that supports breastfeeding, and then communicate the plan to her partner with her consent. Verbalise your reasoning where it helps the patient.^[1]

References5Show

[1]Cox JL, Holden JM, Sagovsky R Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry, 1987.PMID 3651732
[2]Qiu X, Wu Y, Sun Y, Levis B, et al. Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Sci Rep, 2023.PMID 36899016
[3]Bergink V, Rasgon N, Wisner KL Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood. Am J Psychiatry, 2016.PMID 27609245
[4]Wisner KL, Perel JM, Blumer J Serum sertraline and N-desmethylsertraline levels in breast-feeding mother-infant pairs. Am J Psychiatry, 1998.PMID 9585724
[5]Ferrari AJ, Miller PA, Shadid J, Herrera AM, et al. The global prevalence of major depressive disorder during the peripartum period: a systematic review and meta-regression. Lancet Psychiatry, 2026.PMID 42070579

A positive screen and a frightened mother — perinatal mental health communication station

Station brief

References5Show

[1]Cox JL, Holden JM, Sagovsky R Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry, 1987.PMID 3651732
[2]Qiu X, Wu Y, Sun Y, Levis B, et al. Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item. Sci Rep, 2023.PMID 36899016
[3]Bergink V, Rasgon N, Wisner KL Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood. Am J Psychiatry, 2016.PMID 27609245
[4]Wisner KL, Perel JM, Blumer J Serum sertraline and N-desmethylsertraline levels in breast-feeding mother-infant pairs. Am J Psychiatry, 1998.PMID 9585724
[5]Ferrari AJ, Miller PA, Shadid J, Herrera AM, et al. The global prevalence of major depressive disorder during the peripartum period: a systematic review and meta-regression. Lancet Psychiatry, 2026.PMID 42070579