‘My special time’: Australian women's experiences of accessing a specialist perinatal and infant mental health service

Abstract

Women who have few social supports, poor health and a history of stressful life events are at risk of poor mental health during the perinatal period. Infants of parents whose parenting capacity is compromised are also at risk of adverse outcomes. Specifically, poor perinatal mental health can impact maternal-infant attachment. To identify women at risk of poor perinatal mental health, psychosocial assessment and depression screening in the antenatal and early postnatal periods are recommended. This qualitative study is part of a larger mixed methods study, which explored two specialist perinatal and infant mental health (PIMH) services in New South Wales (Australia). Eleven women who had accessed and been discharged from a PIMH service participated in either face-to-face or telephone interviews. Data were transcribed verbatim and analysed thematically. One overarching theme, 'my special time' and three sub-themes, 'there is someone out there for me', 'it wasn't just a job' and 'swimming or stranded: feelings about leaving the service', were identified. The themes describe the women's experiences of being a client of a PIMH service. Overall, women reported a positive experience of the service, their relationship with the clinician being a key component. Findings from this study highlight the importance of the relational aspect of care and support; however, women need self-determination in all therapeutic processes, including discharge, if recovery and self-efficacy as a mother are to be gained. Importantly, further research is needed about how clinicians model a secure base and how mothers emulate this for their infants.

Perceptions and experiences of interventions to prevent postnatal depression. A systematic review and qualitative evidence synthesis

“…It was felt by HCPs that such improved relationships led to enhanced care (Klima et al, 2009;Tanner-Smith et al, 2012). In individual interventions, which included social support interventions and organisation of maternity care interventions (Dennis, 2010;Morrell, 2002;Myors et al, 2014;Scott, 1987) support primarily came from the relationship between the women and the HCP. In these cases that relationship became a very important aspect of the intervention, providing emotional and informational support.…”

“…In these cases that relationship became a very important aspect of the intervention, providing emotional and informational support. Women reported that they were able to rely on the service and that if they needed the service urgently it was available to them; "…the service was closing and I just rang up and was like 'I really need some help', and they called me straight back the next day…(M)y clinical nurse…immediately started seeing me within a week because they…could see how desperate I was for some help…"(participant) (Myors et al, 2014).…”

“…Participants reported that the interventions promoted active participation in their own health care (Wheatley and Brugha, 1999), and building self-esteem and confidence were also reported as resulting from a number of the interventions (Carolan et al, 2012b;Doran and Hornibrook, 2013;Gao et al, 2012;Myors et al, 2014). Recipients of one intervention (Wheatley and Brugha, 1999) reported that they were able to gain information about sensitive subjects such as PND (Wheatley and Brugha, 1999), although, the authors reported that women appeared to want information about PND but were reluctant to ask for this information for fear that they would be thought of as 'going mad'.…”

“…Women also made suggestions for the within session balance of the group discussions such as allowing more time for sharing experiences with peers (Wheatley and Brugha, 1999). Women reported both wanting help and support (Myors et al, 2014) and particularly information about PND (Wheatley and Brugha, 1999) but were reluctant to ask for this due to problems associated with stigma and being intimidated by accessing a service (Myors et al, 2014). (Tanner-Smith et al, 2012).…”

Yonder: Grandparenthood, rural health, diabetes, & perinatal psychiatry

“…In a study published in Health and Social Care in the Community, women who had accessed and been discharged from two such services in the area were interviewed. 5 The participants were overwhelmingly positive describing the service as a 'lifeline', valuing the close relationship developed with 'their' clinician. Importantly, they felt desperate and alone prior to referral, describing hesitancy to request or accept help.…”