This document summarizes data related to perinatal mental health referrals in Far North Queensland between September 2010 and August 2011. It finds that the vast majority (299) of the 300 referrals received during this period were for females. While most referrals were for Australian-born non-Indigenous individuals, referrals of Indigenous women and women from diverse cultural backgrounds were also served. The establishment of a perinatal mental health service in Cairns was found to increase referrals to consultation liaison services in the region.

1. Between the flags, but beyond
the breakers; addressing
Perinatal Mental Health
in calmer, deeper water"
Paul McNamara"
BN (Flin), MMHN (USQ), MHN (Cred.), FACMHN "
Clinical Nurse Consultant"
Perinatal Mental Health"
Cairns & Hinterland Mental Health Service"

2. ! The Concept
! The Context
! The Doing
! The Numbers
! The End"

3. Hickie 2006

5. 0
50
100
150
200
250
300
350
2002-
03
2003-
04
2004-
05
2005-
06
2006-
07
2007-
08
2008-
09
2009-
10
What about Sharks?
Unintentional Drownings [n = 2318] Shark Fatalities [n = 10]
Royal
Surf
Lifesaving
Society
-
Australia
2010
Shark
Research
Institute
Incorporated
2011

7. " The Concept
! The Context
! The Doing
! The Numbers
! The End"

11. Area (square kilometres)
269,227
268,680
227,416
242,514
200000
210000
220000
230000
240000
250000
260000
270000
280000
FNQ
New Zealand
Victoria
United Kingdom

12. Population
269,650
4,413,124
5,550,000
62,649,000
0
10000000
20000000
30000000
40000000
50000000
60000000
70000000
FNQ
New Zealand
Victoria
United Kingdom

13. Density (people per square kilometre)
1
16
24
258
0
50
100
150
200
250
300
FNQ
New Zealand
Victoria
United Kingdom

14. FNQ
Indigenous
Born Overseas
Non-Indigenous Australian-Born
AUSTRALIA
15.4%
16.6% 2.5%
27%
68%
70.5%
ABS 2004 & 2011

16. Data source: CESA

17. 2008-09 to 2012-13!
National Perinatal
Depression Initiative
(NPDI) !

18. " The Concept
" The Context
! The Doing
! The Numbers
! The End"

22. Perinatal Mental Health & Mobile Phones
referred persons WITH a mobile phone [n = 296]
referred persons WITHOUT a mobile phone [n = 4]
Data source:
McNamara, P & Price, C

24. “PMH Pack”
226 mailed from 01/11/10 to 31/08/11

27. " The Concept
" The Context
" The Doing
! The Numbers
! The End"

28. Referrals Received 01/09/10 to 31/08/11
Female [n = 299] Male [n = 1]
Distinct Individuals n = 277
Data source: CIMHA

29. Age Distribution Comparison
0
5
10
15
20
25
15
or
less
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
0
5000
10000
15000
20000
25000
Cairns PMH Australia
ABS 2009a & CIMHA

30. Referrals Received 01/09/10 to 31/08/11
Perinatal Mental Health Only [n = 246]
Previous/Other Mental Health Referral [n = 53]
Data source: CIMHA

31. Referrals Received 01/09/10 to 31/08/11
Accept & Attend Appointment [n = 109]
Phone Contact Only [n = 156]
No Contact [n = 44] Data source: CIMHA

32. Birth @ Cairns Base Hospital
Indigenous Non-Indigenous
Referrals to PMH
Attend PMH Appointment
31%
19%
10%
1st September 2010 to 31st August 2011
Data sources: HBCIS & CIMHA

33. Cultural safety is “an outcome
of nursing and midwifery
education that enables safe
service to be defined by those
that receive the service.”
(Ramsden 2002)

34. Country of Birth
Thailand
Indonesia
Brunei Darussalam
China
Japan
Philippines
India
Cook Islands
Fiji
Samoa
Tonga
New Zealand
Papua New Guinea
United States Of America
Canada
South Africa
Ireland
Italy
England
Australia
83%
17%
1st September 2010 to 31st August 2011
Data source: CIMHA

35. Number
Referred
Number Seen % Referred &
Seen
Australian-Born Non-Indigenous 193 83 43%
Aboriginal and/or Torres Strait
Islander
58 11 19%
Born in Asia 19 4 21%
Born in Oceania 14 4 29%
Born in Europe 10 4 40%
Born in Africa 2 1 50%
Born in North America 2 1 50%
Not Stated 3 0 0%

36. Number
Referred
Number Seen % Referred &
Seen
Australian-Born Non-Indigenous 193 83 43%
Aboriginal and/or Torres Strait
Islander
58 11 19%
Born in Asia 19 4 21%
Born in Oceania 14 4 29%
Born in Europe 10 4 40%

37. " The Concept
" The Context
" The Doing
" The Numbers
! The End ?"

38. perinatal-infant-mh@lists.acmhn.org

39. Acknowledgements
Stella
Phil Smith & James Eales
Mental Health Information Unit
Queensland Health
Debra Smith, Clinical Analyst, Business Finance & Performance Unit, Cairns Base hospital
Cairns Consultation Liaison Team
Cairns & Hinterland Health Service Midwives & Child Health Nurse
Cairns Child & Youth Mental Health Team
Nursing staff of Cairns Mental Health Unit who ‘roadtested’ this presentation
Flowchart graphic design by Freya Horn @ freyadesigns.com
Sarah Davies-Roe
Dee Hellsten
Paul Bailey
& especially the referrers: there is no Perinatal Mental Health service without your service

40. References
• Austin, M-P, Highet, N, and the Guidelines Expert Advisory Committee (2011) Clinical practice guidelines
for depression and related disorders - anxiety, bipolar disorder and puerperal psychosis - in the perinatal
period. A guideline for primary care health professionals. Melbourne: beyondblue: the national depression
initiative
• Australian Bureau of Statistics (2004) Year book Australia, 2004. Issue released 27/02/2004. Canberra,
Australian Capital Territory: Author
• Australian Bureau of Statistics (2009a) Births, Australia, 2009 (3301.0). Issue released 03/11/2010,
Canberra, Australian Capital Territory: Author.
• Australian Bureau of Statistics (2009b) Experimental estimates and predictions, Aboriginal and Torres
Strait Islander Australians, 1991 to 2021 (3238.0). Issue released 08/09/2009, Canberra, Australian
Capital Territory: Author.
• Australian Bureau of Statistics (2010) National regional profile: far north (statistical division). Issue
released 22/11/2010, Canberra, Australian Capital Territory: Author.
• Australian Bureau of Statistics (2011) Migration, Australia, 2009-10 (3412.0). Issue released 16/06/2011,
Canberra, Australian Capital Territory: Author.
• Australian Bureau of Statistics (2011) Population by age and sex, regions of Australia, 2010 (3235.0).
Issue released 04/08/2011, Canberra, Australian Capital Territory: Author.
• Australian Health Ministers’ Advisory Council (2009) Framework for the national perinatal depression
initiative 2008-09 to 2012-13. Retrieved 22 September 2011 from http://www.health.gov.au/internet/
mentalhealth/publishing.nsf/Content/843216139C75B754CA2577B5007B77D5/$File/Final%20Framework
%20for%20the%20NPDI%20June%202009.pdf

41. References
• Department of Foreign Affairs and Trade, The island continent. <www.dfat.gov.au>
• Hickie, I. (2006) Mental health proposals a step forward, says reformer. The 7:30 Report, television
program broadcast 30 March 2006, Australian Broadcasting Corporation. Transcript retrieved 17 April
2011 from www.abc.net.au/7.30/content/2006/s1605134.htm
• Ministry for the Environment, Quick facts about New Zealand. <www.mfe.govt.nz>
• Office for National Statistics, Beginners' guide to UK geography.<www.statistics.gov.uk>
• Ramsden, I. (2002) Cultural Safety: Kawa Whakaruruhau, Massey.
• Royal Surf Lifesaving Society - Australia (2010) The national drowning report. Broadway, New South
Wales: Author
• Shark Research Institute Incorporated (2011) Global shark attack incident log. Retrieved 9 September
2011 from www.sharkattackfile.net/incidentlog.htm
• Statistics New Zealand (2011) Estimated resident population of New Zealand: population clock. Retrieved
17 September 2011 from www.stats.govt.nz/tools_and_services/tools/population_clock.aspx

42. Perinatal Mental Health Cairns
Email PMHcairns@health.qld.gov.au
Phone 07 4226 3411
Mobile 0459 800 267
Fax 07 4226 3460

43. " The Concept
" The Context
" The Doing
" The Numbers
" The End"

44. Referrals per Treating Unit 01/09/10 to 31/08/11
0
200
400
600
800
1000
1200
1400
1600
1800
ACT
ACT
ED
CYMHS
Innisfail
CL
Atherton
Perinatal
Mareeba
MHU
HHOT
Older
Persons
Tully
Remote
Data source: CIMHA

45. Referrals per Treating Unit 01/09/10 to 31/08/11
0
200
400
600
800
1000
1200
1400
1600
1800
ACT
ACT
ED
CYMHS
Innisfail
CL
Atherton
Perinatal
Mareeba
MHU
HHOT
Older
Persons
Tully
Remote
Data source: CIMHA

46. Referrals per Treating Unit 01/09/10 to 31/08/11
0
200
400
600
800
1000
1200
1400
1600
1800 ACT
ACT
ED
CL
+
Perinatal
CYMHS
Innisfail
Atherton
Mareeba
MHU
HHOT
Older
Persons
Tully
Remote
Data source: CIMHA

47. Impact on Referrals to Consultation Liaison
0
100
200
300
400
500
600
700
Sep 2009 to Aug 2010 Sep 2010 to Aug 2011
Consultation Liaison Perinatal
584 615
Data source: CIMHA