Quiz 2: Identifying maternal mental illness

Please choose the one, most correct answer to each question or statement.

1. Why is mental illness often overlooked?
   • Mental illness is not important
   • Care providers may feel uncomfortable having to address mental illness
   • People with mental illness cannot talk about it
   • Mental illness cannot be treated
2. What is stigma?
   • Stigma is caused by mental illness
   • Stigma is the strong disapproval of a characteristic or belief
   • Stigma is an emotional problem
   • Stigma is a complication of mental distress
3. Why are pregnant women often more isolated?
   • Pregnant women want more space because they are growing bigger
   • Pregnant women make new friends who are also pregnant
   • Pregnant women are not more isolated as nothing changes for them
   • Pregnant women’s social networks change because they are not working
4. How can you identify mental distress?
   • Mental distress cannot be identified
   • People with mental distress are usually naked or talking to themselves
   • People with mental distress often complain about aches and pains
   • People with mental distress always tell you they are distressed
5. The interaction between a mother and baby can give you clues about how a mother is feeling. A mother could be experiencing mental distress if:
   • The mother describes the baby as ‘fussy’ or ‘difficult’
   • The mother has lots of milk and is expressing some to bottle feed
   • The mother and baby are communicating well
   • The baby is sleeping through the night
6. What is the ‘door handle’ sign?
   • A keep-out sign on the door
   • A problem that the woman shares when she is about to leave
   • A do not disturb sign for counsellors
   • A sign for doors with broken door handles so that you don’t get locked in by mistake
7. Why is it important to diagnose mental illness early?
   • Mental illness will get better on its own
   • Mental illness is not treatable so one should know early
   • Mental illness stays the same
   • Mental illness may get worse
8. How are women usually screened for common mental disorders?
   • A blood test
   • A questionnaire
   • Health workers look at the behaviour and appearance of the women
   • Blood pressure is monitored
9. Before you start screening, it is important to:
   • Make sure access to mental health care is in place
   • Make sure the woman is physically well
   • Make sure that she is at least 28 weeks pregnant
   • Make sure that her husband has given permission
10. In a busy clinic, if you are unable to screen everyone for mental distress, which group of women should you prioritise to screen:
    • The best dressed
    • Those who have the time
    • Those who can read and write to fill in the questionnaire
    • Adolescents
11. What is confidentiality?
    • Confidentiality is keeping information private
    • Confidentiality is disclosing an HIV status
    • Confidentiality is hiding information from a distressed woman
    • Confidentiality is telling someone information that was told to you in secret
12. A validated screening tool means that:
    • The tool is valuable
    • The screening tool is very sensitive
    • The tool has been used in other countries
    • The tool has been tested against a diagnostic ‘gold standard’ assessment
13. The Edinburgh Postnatal Depression Scale (EPDS) is a questionnaire that assesses:
    • Breastfeeding
    • Bonding
    • Mood
    • Coping with motherhood
14. When screening for depression and anxiety with the Edinburgh Postnatal Depression Scale (EPDS), the questions ask about how the patient felt:
    • Today
    • In the past 7 days
    • In the past month
    • Over the past year
15. When scoring the Edinburgh Postnatal Depression Scale (EPDS) questionnaire, which of the following are TRUE
    • The lower the total EPDS score, the more likely it is that the woman is suffering from anxiety or depression
    • Each question has three right answers
    • You automatically score 13 if you are feeling suicidal
    • The higher the score per question, the more severe the symptom
16. On the Edinburgh Postnatal Depression Scale (EPDS), if a patient has a total score of 13 or more
    • She is probably fine
    • She has the international standard score
    • She is probably experiencing depression or anxiety
    • She only has problems with sleep – but this is usual for pregnant women
17. If a woman has answered that she has thought of suicide on the Edinburgh Postnatal Depression Scale (EPDS) questionnaire, you should:
    • Tell her to think about her baby
    • Contact a psychiatric nurse, sister in charge or doctor for emergency help
    • Ask her about her problems and then send her home
    • Give her advice on coping strategies
18. The Risk Factor Assessment (RFA) is used to assess:
    • How many risks women take during their pregnancy
    • The likelihood that a woman will develop depression or anxiety during pregnancy
    • Risk of mental illness for the baby
    • Risk of a physical illness during pregnancy
19. The following indicate risk on the Risk Factor Assessment (RFA):
    • Family and friends help in practical ways
    • I feel pleased about being pregnant
    • I have a good relationship with my mother
    • I have had some difficult things happen to me in the last year
20. When making a referral, it is helpful to:
    • Tell the mother that her score is endangering the health of her baby
    • Tell the mother she must go to another organisation and get help
    • Explain to the mother what services are on offer and how they may benefit her
    • Explain to the mother that she has a mental problem and has to deal with it by getting counselling