Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public – a systematic review

Abstract

Background The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL. Methods Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively. Results Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public. Conclusions There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole.

Using machine learning to predict help-seeking among 2016–2018 Pregnancy Risk Assessment Monitoring System participants with postpartum depression symptoms

“…Similar to previous research with help-seeking among those with PPD, in this study, variables related to personal depression history were also among the most important predictors for help-seeking for PPD symptoms. 19 , 20 , 24 – 27 Factors such as low mental health literacy, negative attitudes toward help-seeking, and low emotional clarity have all been demonstrated to be related to lack of personal and family experience with depression. 18 , 21 , 24 – 27 Increased levels of mental health literacy have been found to be related to more positive attitudes toward professional mental health help-seeking among recently pregnant individuals.…”

“… 19 , 20 , 24 – 27 Factors such as low mental health literacy, negative attitudes toward help-seeking, and low emotional clarity have all been demonstrated to be related to lack of personal and family experience with depression. 18 , 21 , 24 – 27 Increased levels of mental health literacy have been found to be related to more positive attitudes toward professional mental health help-seeking among recently pregnant individuals. 27 Recent research suggests that recently pregnant individuals and the public have misperceptions regarding perinatal mental health disorders in terms of symptoms, severity, risk, difference from “the baby blues,” and treatment, and these misperceptions can influence help-seeking.…”

“…Pregnant people with lower incomes may not be able to afford care because of lack of insurance coverage, less paid leave from work, childcare coverage, or transportation costs. 17 , 23 – 26 Race and ethnicity are associated with social barriers such as lack of trust in the healthcare system, lack of culturally sensitive care, or cultural beliefs that stigmatize help-seeking. 19 , 20 , 23 – 28 Education and mental health literacy are also germane.…”

“… 17 , 23 – 26 Race and ethnicity are associated with social barriers such as lack of trust in the healthcare system, lack of culturally sensitive care, or cultural beliefs that stigmatize help-seeking. 19 , 20 , 23 – 28 Education and mental health literacy are also germane. If a person or a family member has sought help in the past, they usually have a better understanding of symptoms and the benefits of mental health services and how to access them.…”

“…If a person or a family member has sought help in the past, they usually have a better understanding of symptoms and the benefits of mental health services and how to access them. 17 – 27 …”