ORIGINAL RESEARCH Feasibility and Preliminary Responses to a Screening and Brief Intervention Program for Maternal Mental Disorders Within the Context of Primary Care Katherine Sorsdahl • Petal Petersen Williams • Kathy Everett-Murphy • Bavi Vythilingum • Patricia de Villiers • Bronwyn Myers • Dan J. Stein Received: 29 July 2014 / Accepted: 23 February 2015 Ó Springer Science+Business Media New York 2015 Abstract There is little evidence of the feasibility and acceptability of integrating screening, brief intervention and referral to treatment services that address depression and alcohol, tobacco and other drug (ATOD) use into an- tenatal care in South Africa. Data were extracted from program records on the number of eligible women screened and number meeting criteria for depression and self-re- ported ATOD use. 70 women completed a questionnaire examining their preliminary responses and five MOU personnel were interviewed to identify potential barriers to implementation. Of the 3407 eligible women, 1468 (43 %) women were screened for depression or ATOD use, of whom 302 (21.4 %) screened at risk for depression, 388 (26.4 %) disclosed smoking tobacco, and 29 (2 %) disclosed alcohol or other drugs (AOD). Seventy par- ticipants completed the three month follow-up interview. Depression scores decreased significantly following the intervention (t (69) = 8.51, p \ 0.001) as did self-reported tobacco use (t (73) = 3.45, p \ 0.001), however self-re- ported AOD use remained unchanged. Keywords Service delivery Á Maternal mental health Á Tobacco, alcohol and drug use Background Mental health problems such as depression and substance use disorders are highly prevalent in low and middle in- come countries (LMIC) such as South Africa (SA). Studies investigating the prevalence of perinatal depression in SA have yielded results ranging from 17 to 47 % during pregnancy (Rochat et al. 2011; Rotheram-Borus et al. 2011) and between 16 and 35 % in the postnatal period (Cooper et al. 1999; Ramchandani et al. 2009). Other studies have highlighted high levels of alcohol, tobacco and other drug (ATOD) use during pregnancy. For example, one study reported that 46 % of women of mixed ancestry smoked tobacco throughout pregnancy (Petersen et al. 2009). Additionally, a representative survey among preg- nant women attending public sector antenatal clinics in the Cape Town area, reported that 8.8 % tested positive for at least one illicit drug with urine analysis. This is higher than the self-reported prevalence (3.6 %). In addition, 19.6 % tested positive for alcohol which is lower than the self- reported prevalence (36.9 %) (Petersen Williams et al. 2014). Undetected and untreated mental health problems pose significant risks for maternal well-being and infant health. K. Sorsdahl Alan. J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa K. Sorsdahl (&) Á B. Vythilingum Á B. Myers Á D. J. Stein Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa e-mail: katherine.sorsdahl@uct.ac.za P. Petersen Williams Á B. Myers Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council, Tygerberg, South Africa K. Everett-Murphy Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa P. de Villiers Western Cape Department of Health, Cape Town, South Africa D. J. Stein Unit on Anxiety and Stress Disorders, Medical Research Council, Tygerberg, South Africa 123 Community Ment Health J DOI 10.1007/s10597-015-9853-9