The PMHP provides free therapeutic counselling at the same time and place where women attend for antenatal care.

Counselling is one way to support women in distress. It offers distressed women an opportunity and a safe space to tell their stories without fear of being blamed or judged. In a time of crisis, counselling gives women the opportunity to contain their distress, highlight their priorities and identify possible resources. This support empowers women to take the lead in managing their own problems in the future.

I am struck by both the quantity and nature of the horrors facing our clients. Our counsellor works with women on gang rape, homelessness, HIV, domestic violence, social isolation, and childhood sexual abuse – often with three or four of these confronting one woman. However,  it is equally remarkable that so many of these women, with a small amount of structured emotional and practical support, are able to draw on their resilience, cope with their circumstances, and care for their children.
Dr Simone Honikman
PMHP Director

What kind of counselling is provided?

The PMHP provides individual, face-to-face counselling by a trained counsellor. The counsellor assesses each client and adopts a flexible approach to suit individual needs. These interventions may include containment, psycho-education, bereavement counselling, debriefing of traumatic incidents, relaxation and breathing exercises, couple and family counselling, as well as suicide and impulse risk management. The PMHP maintains a continuum of care for all clients into the postnatal period.

For many women, the number of face-to-face sessions may be limited by their own practical constraints. On average, the number of sessions per client is between two and three. The counsellor also liaises with external agencies, social services or support organisations to ensure a comprehensive continuum of care for her clients. The counsellor may also provide additional support by telephone. For more serious cases, the counsellor may refer to the Mental Health Team at the nearby Community Health Centre. 

Less frequent than conventional therapy sessions, PMHP counselling is effective in that it provides a space for containment, empathy and positive regard at a time of crisis or distress. This is an intervention that provides meaningful support necessary to empower women and girls to identify resources and personal capabilities. This can enhance their resilience to difficult life circumstances and support them to nurture their children optimally.

In 2020, to augment the PMHP service, we have added a part-time, junior-level counsellor, to Engage, Assess and Triage (EAT) all positively screened women into low-intensity versus high-intensity care.

Low-intensity care involves counselling (and possibly, group support) facilitated by the junior counsellor while high-intensity care involves counselling and psychotherapeutic interventions from the more experienced, professional counsellor.

The aim of this stepped-care approach is to ensure greater intervention coverage of the vulnerable population using the MOU. This combined with distance-based support, established during the COVID-19 pandemic, is described in the new PMHP Adapted Service Flow Diagram below:

Read more about counselling in our Basic Counselling Skills handbook here.

Does it work?

The PMHP incorporates a rigorous monitoring and evaluation process into its service programme. Statistical analysis of client logs and counselling data shows that, on average 

Read the latest outcomes report here

  • 93 % report positive bonding with their baby
  • 69 % report a positive life experience at the time of assessment
  • 57%   report that their main problem is ‘much improved’ or ‘resolved’ after counselling

Our analysis shows that PMHP counselling has a beneficial impact on clients, in terms of mood, coping, and general functioning. We have also shown that our intervention builds the clients’ assertiveness and resilience to face the challenges of motherhood in difficult social and economic conditions.


Experiences from our counsellor 

Liesl Hermanus | Hanover Park Midwife Obstetric Unit

One of the biggest challenges I recall while doing my internship in Hanover Park in 2007 was accepting the little I was able to do for my clients. Five years later, I find myself back in this community and have come to the realisation that the little I thought I was doing back then could possibly have meant a lot and made a big difference to those I was trying to assist. Most of my clients don’t have any support, and for most of these women counselling will be the first time that they have the space to express their worries and anxieties and, more importantly, the first time that they will feel heard and understood.

There is a great need for the service in Hanover Park and surrounding areas. It has been an amazing experience seeing the Hanover Park PMHP site transition from a research to a service site, and a smooth transition at that. The MOU staff have long been waiting for this. They and the community are truly embracing the service. Having CASE and the Parent Centre on board has added so much more value to our site. Essentially we are all working towards a common goal, to improve the lives of those in and around Hanover Park be it through mental health services, support groups or parenting workshops. 

Beautiful News South Africa Many pregnant women become depressed and anxious in the face of poverty and violence. Watch how Liesl Hermanus is ensuring they get the mental healthcare they need.