Background Task sharing has been used worldwide to improve access to mental health care, where nonspecialist providers—individuals with no formal training in mental health—have been trained to effectively treat perinatal depressive and anxiety symptoms. Little formative research has been conducted to examine relevant barriers and facilitators of nonspecialist providers and the use of telemedicine in treatment service delivery. Objective The primary objective of this study was to examine the main barriers and facilitators of nonspecialist provider–delivered psychological treatments for perinatal populations with common mental health disorders, such as depression and anxiety, from a multistakeholder perspective. Methods This study took place in Toronto, Canada. In total, 33 in-depth interviews were conducted with multiple stakeholder groups (women with lived experience and their significant others, as well as health and mental health professionals). Qualitative data were quantified to estimate commonly endorsed themes within and across stakeholder groups. Results Psychological treatments delivered by nonspecialist providers were considered acceptable by the vast majority of participants (30/33, 90%). Across all stakeholder groups, nurses (20/33, 61%) and midwives (14/33, 42%) were the most commonly endorsed cadre of nonspecialist providers. The majority of stakeholders (32/33, 97%) were amenable to nonspecialist providers delivering psychological treatment via telemedicine (27/33, 82%), although concerns were raised about the ability to establish a therapeutic alliance via telemedicine (16/33, 48%). Empathy was the most desired characteristic of a nonspecialist provider (61%). Patient and patient advocate stakeholders were more likely to emphasize stigma as an important barrier to accessing psychological treatments (7/12, 58%), compared to clinicians (2/9, 22%) and spouses (1/5, 20%). Clinician stakeholders were more likely to emphasize the importance of ensuring nonspecialist providers were trained to deliver psychological treatments (3/9, 33%), compared to other stakeholder groups. Conclusions These results can inform the design, implementation, and integration of nonspecialist-delivered interventions via telemedicine for women with perinatal depressive and anxiety symptoms in high-income country contexts.

BACKGROUND Task-sharing has been used worldwide to improve access to health care, where non (mental health) specialist providers—individuals with no formal training in mental health—have been educated to effectively treat perinatal depressive and anxiety symptoms. Little formative research has been conducted to determine the acceptability and feasibility of non-specialist providers and the use of digital solutions like telemedicine in treatment service delivery. OBJECTIVE The primary objective of this study was to examine the acceptability and feasibility of non-specialist provider-delivered psychological treatments for the perinatal population with depression from a multi-stakeholder perspective. METHODS The study took place in Toronto, Canada. N=33 in-depth interviews were conducted with multiple stakeholder groups (women with lived experience, their significant others, as well as health and mental health clinicians). Qualitative data was quantified to estimate commonly endorsed themes within and across stakeholder groups. RESULTS Psychological treatments delivered by non-specialist providers was considered acceptable and feasible by the vast majority of participants (n=30 of 33; 90%). Nurses and midwives were the most commonly endorsed cadre of non-specialist providers. Most stakeholders were amenable to non-specialist providers delivering psychological treatment via telemedicine although concerns were raised about the ability to establish a therapeutic alliance. There was minimal different between stakeholder groups. However, patient stakeholders emphasized stigma as an important barrier to accessing psychological treatments and clinician stakeholders emphasized the importance of ensuring non-specialist providers were well-trained to deliver psychological treatments. CONCLUSIONS These results can inform the scalability of non-specialist delivered interventions and the design of future studies involving psychological treatments delivered by NSPs and via telemedicine delivered for women with perinatal depressive and anxiety symptoms. In light of COVID-19, the implications of scaling up psychological treatments through telemedicine and non-specialist providers are particularly relevant to address the burden of perinatal mental health. CLINICALTRIAL Not applicable