Evaluation of a national helpline service (ForWhen) to support perinatal and infant mental health

The ForWhen program is a national Australian navigation service which helps to connect parents and carers experiencing mental health concerns during the perinatal period with appropriate mental health support in their local area. Clients access the service by contacting the ForWhen helpline, which connects them to a ForWhen Navigator located in their state/territory. ForWhen Navigators assess clients' mental health concerns and needs, offer emotional support and psychoeducation, and coordinate referrals for clients experiencing moderate to severe perinatal and infant mental health concerns to professional mental health support. ForWhen navigators are clinically trained professionals (e.g., nurses, social workers, psychologists) employed on the program. Navigators conduct an initial assessment with all clients lasting approximately 60 minutes. Navigators typically conduct follow-up with clients to offer further emotional support and psychoeducation, and ensure they have successfully accessed referred services, although the frequency and overall duration of follow-up varies based on individual client needs (e.g., once per week for 4 weeks, until first appointment with a perinatal psychologist). This study is an evaluation of the ForWhen program. The ForWhen program is available to anyone who wishes to access it, regardless of whether or not they choose to participate in this study. A mixed-methods evaluation design will be utilised, including a review of de-identified routinely collected service data between February 2022 and June 2024, and a range of additional qualitative and quantitative data collected at various points over the 3-year evaluation period in order to achieve the evaluation aims. Routinely collected service data includes data relating to individual clients and service provision collected by navigators and managed via a Customer Relationship Management (CRM) database. At program entry (baseline), navigators administer the Kessler Psychological Distress Scale (K10) as part of a routine mental health assessment, and collect client data including demographic information and identified psychosocial risk factors during an intake interview. Throughout each client’s engagement with the program, individual service provision data including number and mode of contacts with the navigator, services provided by the navigator (e.g., psychoeducation), and the number and types of referrals made, are routinely recorded by navigators in the CRM database. At program exit (discharge), an optional survey is emailed to participants which assesses satsifaction with the ForWhen program. At follow-up (10 weeks post-discharge), an additional optional survey is emailed to participants, which includes the K10 and questions about engagement with referred services. During a 6-month period in the second year of the program, the research/evaluation team will recruit ForWhen clients to an opt-in ‘snapshot study’ to evaluate the program’s impact on additional parent and infant outcomes. All clients who access ForWhen during this study period will be eligible to participate, and will receive an invitation phone call from a member of the research team within one week of their first contact with the ForWhen navigator. Those who opt-in will be asked to complete a series of validated questionnaires at baseline (within one week of accessing the service) and follow-up (10-12 weeks after program exit) either online or over the phone with a member of the research team. These questionnaires will take approximately 10-20 minutes to complete. Participants will provide written informed consent for this data to be linked to their client information held in the CRM database. Finally, clients who opt to participate in the 'snapshot study' will be invited to participate in a semi-structured interview about their experiences with the ForWhen program during the 10-12 week follow-up. Those who opt-in will complete a debrief interview with a member of the research team via phone, lasting approximately 15-20 mins. Semi-structured interviews will also be conducted with stakeholders (navigators, managers, steering committee members) of the ForWhen program during Yr 1 and Yr 3 of its implementation. ForWhen stakeholders will be invited to participate in these interviews by a member of the research/evaluation team via email and will provide informed written consent. Interviews will be conducted via video conferencing software or phone, and last approximately 60 minutes.