Examining the effectiveness of a coordinated perinatal mental health care model using an intersectional-feminist perspective

Abstract

Untreated perinatal depression and anxiety are significant public health problems that disproportionately affect ethno-racial minorities. The purpose of this study was to examine the effectiveness of a coordinated perinatal mental health care model, focusing on socially-disadvantaged, ethno-racial minority women, with an intersectional-feminist perspective. The treatment model was grounded in intersectionality theory with the aim of addressing complex social vulnerability factors in the context of perinatal mental health treatment. Participants were 67 perinatal women (64% African American or Hispanic/Latina) referred by medical providers at an urban teaching hospital. Results demonstrated high treatment engagement and effectiveness, with 65.9% of participants demonstrating reliable improvement in symptoms. Moreover, African American and Hispanic/Latina patients had similar treatment outcomes compared to White patients, despite facing greater socio-economic disadvantages. Findings indicate that the treatment model may be a promising approach to reducing perinatal mental health disparities. Strengths and limitations of the study are discussed within the intersectionality framework.

Clinical case study of abbreviated cognitive behavioral therapy through an intersectional lens for women health-care workers during the era of COVID-19.

“…Social justice is able to be integrated into CBT principles by identifying and modifying beliefs and cognitions attributed to marginalizing systemic factors, which must be conducted in a parallel process of providers recognizing their own axes of power, privilege, and oppression and how their own identities may affect patient psychological safety and treatment. Moreover, CBT has also been successfully utilized from an intersectional-feminist perspective for treating perinatal mental health care (Stevens et al, 2018), anxiety among diverse populations (Graham et al, 2013), and depression experienced among Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals (Ross et al, 2007). CBT has also been discussed by Watts as having “potential” to “[transform] political consciousness,” (Watts, 2004).…”

“…The strong relevance of intersectionality and the demonstrated utility of CBT provide the rationale for this case study's approach. Intersectionality may be especially poignant to consider for WHCWs' unique experiences such as women's health disparities (Kelly, 2009), perinatal mental health care (Stevens et al, 2018), and cultural identities in health psychology (Dixon, 2019) that will be demonstrated in this case when applicable. This patient's treatment will exemplify how we conceptualize patients with intersectional identities while imparting concrete tools to increase balanced cognitive processes in the COVID-19 crisis.…”

Black Women’s Preferences for Embedding Mental Health Services in An Obstetrics Setting

“…These OB visits afford opportunities to connect with patients and allow the development of a quality provider-patient relationship. Recognizing perceived barriers and facilitating treatment have been shown to enhance treatment seeking (Byatt et al, 2012;Ward et al, 2013;Stevens et al, 2018). Thus, mental health services might be more likely to be accessed by low-income black women if mental health care is embedded within a patient's OB visit.…”

Filling the GAAAPPS: Generating affirming Asian American perinatal psychological services.

“…Participants reported mistreatment and felt like they could not relate to their providers culturally (Leis et al, 2011). Stevens et al (2018) examined the effectiveness of a coordinated PMH model with socially disadvantaged, racial/ethnic minority women, who predominantly identified as Black/African American or Hispanic/Latina. The model utilized intersectionality theory and conceptualized vulnerability through the lens of power versus oppression and sought to understand how social environments support perinatal women's mental well-being or actively undermine it.…”