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

Abstract

Background and aimsIn 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?MethodSemi-structured interviews were conducted with Black and South Asian women (n = 37), including four women who were interviewed with an interpreter. Interviews were recorded and transcribed line-by-line. Data were analyzed using framework analysis, by an ethnically diverse multidisciplinary team of clinicians, researchers and people with lived experience of perinatal mental illness.ResultsParticipants 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.ConclusionWomen 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.

Healthcare professionals’ views on the accessibility and acceptability of perinatal mental health services for South Asian and Black women: a qualitative study

“…These findings should be considered alongside, and as complementary to, research exploring Black and South Asian women’s experiences of support from perinatal mental health services. This study found that women who did access services encountered complex interlayer barriers, and many struggled to access support from services despite repeated insistent attempts [ 17 ].…”

The Behavior of Seeking Professional Psychological Help Among Pregnant Women: A Qualitative Study in China

“…(3) Coding recurring viewpoints; (4) Collecting coded views to nd common meaningful concepts and form preliminary themes; (5) Providing detailed descriptions of each theme generated in the previous step, and extracting the original statements from the interviewees; (6) Grouping similar themes and their descriptions for repeated comparison, discerning and extracting similar viewpoints, then constructing a concise and meaningful phrase, namely, the theme; (7) Returning the generated theme structure to the interviewees for validation, asking if it captures their real experience to ensure the accuracy of the results.…”

“…Research both domestically and internationally indicates that pregnant women, due to multiple pressures such as physiological changes and environmental adaptation, are more prone to mental health problems, yet they exhibit a de ciency in behaviors seeking professional psychological help [4]. Only about 12-35% of pregnant women will actively seek professional psychological help [4][5][6][7][8][9][10]. The lack of professional psychological help-seeking behavior not only affects their mental health but also impacts the development of the infant and the harmony of the family [8,11].…”

Unequal Care: Examining the intersection of multifactorial factors contributing to suboptimal perinatal outcomes: A scoping review and implications for perinatal services in the UK

“…Black and south Asian women appeared to be less likely to seek help and engagement in perinatal mental health services in the UK than their while British counterparts, although they may have similar, or higher levels of mental distress. Themes of self-identity and social expectations deterred seeking help 43 . Services that were not clearly visible (hidden) or disorganized made getting support more di cult 44 .…”

“…Kindness, curiosity, and exibility in making women feel heard, accepted, and supported by clinicians was important 45 . Interestingly, a shared cultural background was noted to both support and be detrimental to building rapport and trust 43 .…”