Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK

Abstract

Perinatal depression among Black Caribbean women in the UK remains an intriguingly under-researched topic. Despite high levels of known psychosocial risks, Black Caribbeans remain relatively invisible among those seeking/receiving help for depression during and after pregnancy.In-depth interviews were undertaken with a purposive sample of twelve Black Caribbean women selected from a lager sample (n=101) to examine prevalence and psychosocial risks for perinatal depression among this ethnic group. The study also sought to explore women's models of help-seeking. During analysis, the context in which help-seeking/giving is mediated emerged as a key issue. We explore the nature of these encounters thereby opening up the possibility of finding common ground between service users and providers for enabling women to receive the care and support they need.Whether or not women configure depressive feelings as 'symptoms' requiring external validation and intervention is a reflection both of the social embeddedness of those individuals and of how 'help-givers' perceive them and their particular needs. We suggest that the ways in which helpseeking/giving are commonly conceptualised might offer at least a partial explanation for apparently low levels of diagnosed perinatal depression among Black Caribbean women. Popular approaches to health seeking behaviours within health promotion and practice focus on individuals as the fulcrum for change, tending to overlook their embeddedness within 'reflexive communities'. This might serve to reinforce the invisibility of Black Caribbean women both in mainstream mental health services and associated research. Alternative approaches may be required to achieve government targets to reduce inequalities in access, care, and treatment and to deliver more responsive and culturally-appropriate mental health services.

Seeking help for perinatal psychological distress: a meta-synthesis of women’s experiences

“…Nine explored this concept in minority groups living in the UK (15)(16)(17)(18)(19)(20)(21)(22)(23). Three studies had mixed samples (24)(25)(26), five had predominantly White samples (27-31) and seven did not report ethnicity (32)(33)(34)(35)(36)(37)(38).…”

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

“…7 Fifteen studies provided data from participants who were part of the general population in the country of study, whereas the remaining studies examined evidence from minority groups within the country of study. The minority groups either were a culturally different group based within the country of study (n = 5) 304,[306][307][308][309][310][311]314,318 or were a selective group (n = 3). 292,[296][297][298]315 For details of participant characteristics, see Appendix 9.…”

“…Ten studies were conducted in the UK, 304,[306][307][308][309][310][311][312][313][314][315]319,321,322,324 seven studies were conducted in the USA, 286,292,[296][297][298]302,303,318,320 one in Switzerland, 316 one in Canada, 317 one in Norway, 323 one in India, 325 one in China 305 and one in multiple centres. 7 …”

Barreras de acceso a tratamiento de la depresión posparto en Centros de Atención Primaria de la Región Metropolitana: un estudio cualitativo

“…En conjunto con lo señalado, se ha referido que un ideal de maternidad exigente, compartido por las mujeres y su entorno, genera temor a no cumplir con las expectativas y reticencia a aceptar emociones negativas no validadas socialmente [24][25][26] . La importancia atribuida a la comunicación adecuada de la sospecha de DPP es respaldada por investigaciones recientes que sugieren la necesidad de entrenamiento del personal de salud para efectuar un proceso de detección integrado a la práctica clínica, que contemple la psicoeducación y acompañamiento a mujeres con sospecha de DPP 27,28 .…”