scholarly journals Inequalities in the identification and management of common mental disorders in the perinatal period: An equity focused re-analysis of a systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248631
Author(s):  
Stephanie L. Prady ◽  
Charlotte Endacott ◽  
Josie Dickerson ◽  
Tracey J. Bywater ◽  
Sarah L. Blower
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Ethnic Minority ◽  
Mental Health Problems ◽  
Perinatal Period ◽  
Health Problems ◽  
Minority Women ◽  
Perinatal Mental Health ◽  
Ethnic Minority Women ◽  
Current Guidance

Objective Maternal mental health problems in the perinatal period can cause significant distress and loss of functioning, and can have lasting impact on children. People living in disadvantage are at risk of health inequalities, including for perinatal mental health. A review of current guidance found that overall implementation of the UK detection and management strategy was satisfactory, but equity was not considered in the review. Greater understanding of implementation equity is needed. We aimed to reanalyse an existing systematic review on the implementation of current guidance for the identification and management of perinatal mental health problems for equity. Methods Studies reporting the presence or absence of variation by a social, economic or demographic group were quality appraised and the presence and direction of disparity tabled. We calculated standardised absolute prevalence estimates for overall detection and management, and absolute and relative estimates by determinants grouping. A thematic analysis of the studies that examined potential reasons for disparity was undertaken. Results Six studies, with no major quality concerns, provided consistent evidence of reduced identification and management for ethnic minority women, both those who do, and do not, speak English. There was less consistent evidence of inequality for other axes of social disparity and for characteristics such as age, parity and partnership status. Explanations centred on difficulties that translation and interpretation added to communication, and hesitancy related to uncertainty from healthcare providers over cultural understanding of mental health problems. Conclusion The identification and management of perinatal mental health problems is likely to be inequitable for ethnic minority women. Further systems-based research should focus on clarifying whether other groups of women are at risk for inequalities, understand how mismatches in perception are generated, and design effective strategies for remediation. Inequalities should be considered when reviewing evidence that underpins service planning and policy decision-making.

scholarly journals Experiences and expectations of women from ethnic minority background on perinatal mental health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Soltani ◽  
H Watson ◽  
E Walton ◽  
D Harrop ◽  
A Young ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Ethnic Minority ◽  
Qualitative Data ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Community Support ◽  
Health Problems ◽  
Perinatal Mental Health ◽  
Care Providers

Abstract Introduction Being from ethnic minority backgrounds is a risk factor for poor perinatal mental health (PMH). To enhance services and prevent the devastating impacts of mental health problems on maternal morbidity and mortality, it is important to understand the experiences and expectations of women and families regarding related service provisions. Methods This will present the results of a two staged study including: a) a systematic review examining the state of evidence on the experiences of women from ethnic minority backgrounds on PMH. We searched 4 databases and using a convergent approach, synthesised the data thematically. b) an exploratory survey, distributed through a maternity service user and parenting Facebook group. Quantitative data were analysed using descriptive statistics and a thematic analysis was used for the qualitative data. Results A total of 15 studies met the inclusion criteria for the systematic review, highlighting the need for an in-depth exploration of these women with issues related to culture stigma and relevance of care provision. The survey questions explored these issues further. There were 51 responses representing 14 different ethnic minority backgrounds, the largest groups being Pakistani and Indian (21.6% and 19.6% respectively). The majority of the respondents reported accessing support for mental health problems very challenging (58.5%). Qualitative data revealed several overarching themes; 'Suffering in silence', 'The need for a safe space to talk' 'What about women like me-community support'? Conclusions Women from ethnic minority groups face barriers to seeking help from PMH services due to ongoing stigma, poor attitudes and behaviours of health professionals and inappropriately designed services. Culturally competent care providers with appropriate training are required to ensure women feel safe to access care. The effects of peer supporters as part of PMH services require further investigation. Key messages Maternity services should ensure that support for perinatal mental ill health meets the needs of women from ethnic minorities. Research is needed to develop interventions on healthcare professionals' education and cultural competency and services which promote access to culturally appropriate spaces to talk and be listened to.

scholarly journals The Perinatal Mental Health of Indigenous Women: A Systematic Review and Meta-Analysis

2019 ◽  
pp. 070674371987702 ◽  
Author(s):  
Sawayra Owais ◽  
Mateusz Faltyn ◽  
Ashley V. D. Johnson ◽  
Chelsea Gabel ◽  
Bernice Downey ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Well Being ◽  
Health Problems ◽  
Indigenous Women ◽  
Perinatal Mental Health ◽  
Future Research ◽  
Increased Risk

Objective: Although Indigenous women are exposed to high rates of risk factors for perinatal mental health problems, the magnitude of their risk is not known. This lack of data impedes the development of appropriate screening and treatment protocols, as well as the proper allocation of resources for Indigenous women. The objective of this systematic review and meta-analysis was to compare rates of perinatal mental health problems among Indigenous and non-Indigenous women. Methods: We searched Medline, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until February 2019. Studies were included if they assessed mental health in Indigenous women during pregnancy and/or up to 12 months postpartum. Results: Twenty-six articles met study inclusion criteria and 21 were eligible for meta-analysis. Indigenous identity was associated with higher odds of mental health problems (odds ratio [ OR] 1.62; 95% confidence interval [CI], 1.25 to 2.11). Odds were higher still when analyses were restricted to problems of greater severity ( OR 1.95; 95% CI, 1.21 to 3.16) and young Indigenous women ( OR 1.86; 95% CI, 1.51 to 2.28). Conclusion: Indigenous women are at increased risk of mental health problems during the perinatal period, particularly depression, anxiety, and substance misuse. However, resiliency among Indigenous women, cultural teachings, and methodological issues may be affecting estimates. Future research should utilize more representative samples, adapt and validate diagnostic and symptom measures for Indigenous groups, and engage Indigenous actors, leaders, and related allies to help improve the accuracy of estimates, as well as the well-being of Indigenous mothers, their families, and future generations. Trial Registration: PROSPERO-CRD42018108638.

scholarly journals “Mental health support is like a secret society”: A qualitative study of the impact of peer support on women’s mental health treatment experiences during the perinatal period.

2021 ◽  
Author(s):  
Chloe Rice ◽  
Emma Ingram ◽  
Heather O’Mahen
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Peer Support ◽  
Mental Health Problems ◽  
Perinatal Period ◽  
Health Problems ◽  
Perinatal Mental Health ◽  
Formal Support ◽  
Mental Health Support ◽  
Health Support

Abstract Background Perinatal mental health problems are prevalent, affecting up to 20% of women However, only 17–25% receive formal support during the perinatal period. In this qualitative study, we sought to examine women’s experiences with peer support for mental health problems during the perinatal period. Methods Semi-structured interviews and focus groups were conducted with twenty-five mothers from the UK who had utilised peer support for a perinatal mental health problem. Data was analysed using thematic analysis. Results Seven major themes were identified in women’s help seeking process and experience of peer support. These included; perinatal specific precipitating factors that contributed to their mental health problems, barriers in the form of unhelpful professional responses, feelings of isolation, acceptance of the problem and need to actively re-seek support, finding support either through luck or peer assistance. Conclusions Peer support showed promise as an effective means to reduce perinatal mental health difficulties; either as a form of formal support or as an adjunct to formal support. The results highlight ways to improve perinatal women’s access to mental health support through peer-based mechanisms.

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