Exploring Black and South Asian women's experiences of help-seeking and engagement in perinatal mental health services in the UK.

ethnic minority framework analysis (FWA) health inequality marginalized and vulnerable groups minoritisation perinatal mental health qualitative study

Journal

Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006

Informations de publication

Date de publication:
2023
Historique:
received: 09 12 2022
accepted: 06 03 2023
medline: 20 4 2023
pubmed: 20 4 2023
entrez: 20 04 2023
Statut: epublish

Résumé

In the United Kingdom (UK), Black and South Asian women are less likely than White British women to access support from perinatal mental health services, despite experiencing similar, or higher, levels of distress. This inequality needs to be understood and remedied. The aim of this study was to answer two questions: how do Black and South Asian women experience (1) access to perinatal mental health services and (2) care received from perinatal mental health services? Semi-structured interviews were conducted with Black and South Asian women ( Participants described a complex interplay of factors that impacted on seeking, and receiving help, and benefiting from services. Four themes emerged that captured the highly varied experiences of individuals: (1) Self-identity, social expectations and different attributions of distress deter help-seeking; (2) Hidden and disorganized services impede getting support; (3) The role of curiosity, kindness and flexibility in making women feel heard, accepted and supported by clinicians; (4) A shared cultural background may support or hinder trust and rapport. Women described a wide range of experiences and a complex interplay of factors impacting access to, and experience of, services. Women described services as giving them strength and also leaving them disappointed and confused about where to get help. The main barriers to access were attributions related to mental distress, stigma, mistrust and lack of visibility of services, and organizational gaps in the referral process. These findings describe that many women feel heard, and supported by services, reporting that services provide a high quality of care that was inclusive of diverse experiences and understandings of mental health problems. Transparency around what PMHS are, and what support is available would improve the accessibility of PMHS.

Sections du résumé

Background and aims UNASSIGNED
In the United Kingdom (UK), Black and South Asian women are less likely than White British women to access support from perinatal mental health services, despite experiencing similar, or higher, levels of distress. This inequality needs to be understood and remedied. The aim of this study was to answer two questions: how do Black and South Asian women experience (1) access to perinatal mental health services and (2) care received from perinatal mental health services?
Method UNASSIGNED
Semi-structured interviews were conducted with Black and South Asian women (
Results UNASSIGNED
Participants described a complex interplay of factors that impacted on seeking, and receiving help, and benefiting from services. Four themes emerged that captured the highly varied experiences of individuals: (1) Self-identity, social expectations and different attributions of distress deter help-seeking; (2) Hidden and disorganized services impede getting support; (3) The role of curiosity, kindness and flexibility in making women feel heard, accepted and supported by clinicians; (4) A shared cultural background may support or hinder trust and rapport.
Conclusion UNASSIGNED
Women described a wide range of experiences and a complex interplay of factors impacting access to, and experience of, services. Women described services as giving them strength and also leaving them disappointed and confused about where to get help. The main barriers to access were attributions related to mental distress, stigma, mistrust and lack of visibility of services, and organizational gaps in the referral process. These findings describe that many women feel heard, and supported by services, reporting that services provide a high quality of care that was inclusive of diverse experiences and understandings of mental health problems. Transparency around what PMHS are, and what support is available would improve the accessibility of PMHS.

Identifiants

pubmed: 37077277
doi: 10.3389/fpsyt.2023.1119998
pmc: PMC10109459
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1119998

Informations de copyright

Copyright © 2023 Conneely, Packer, Bicknell, Janković, Sihre, McCabe, Copello, Bains, Priebe, Spruce and Jovanović.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Maev Conneely (M)

Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
East London NHS Foundation Trust, London, United Kingdom.

Katy C Packer (KC)

Camden and Islington NHS Foundation Trust, London, United Kingdom.
North East London NHS Foundation Trust, London, United Kingdom.

Sarah Bicknell (S)

Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom.

Jelena Janković (J)

Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom.
School of Psychology, University of Birmingham, Birmingham, United Kingdom.

Harpreet Kaur Sihre (HK)

Department of Applied Health Research, University College London, London, United Kingdom.

Rosemarie McCabe (R)

School of Health and Psychological Sciences, City, University of London, London, United Kingdom.

Alex Copello (A)

Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom.
School of Psychology, University of Birmingham, Birmingham, United Kingdom.

Kiren Bains (K)

Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom.
School of Psychology, University of Birmingham, Birmingham, United Kingdom.

Stefan Priebe (S)

Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
East London NHS Foundation Trust, London, United Kingdom.

Amy Spruce (A)

Action on Postpartum Psychosis, London, United Kingdom.

Nikolina Jovanović (N)

Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
East London NHS Foundation Trust, London, United Kingdom.

Classifications MeSH