Young mothers’ use of and experiences with mental health care services in Ontario, Canada: a qualitative descriptive study

Abstract

Background Despite the high prevalence of mental health issues among young mothers, their subsequent needs for mental health care support does not correlate with their access and use of services. The purpose of this study, grounded in the experiences of young mothers living in Ontario, Canada, was to describe their experiences of using mental health services during the perinatal period, and to identify the attributes of services and professionals that influenced their decision to engage with mental health services. Methods As the qualitative component of a sequential explanatory mixed methods study, the principles of qualitative description informed sampling, data collection, and analysis decisions. In-depth, semi-structured interviews were conducted with a purposeful sample of 29 young mothers (≤ 21 years) who met diagnostic criteria for at least one psychiatric disorder, and who were ≥ 2 months postpartum. Interview data were triangulated with data from ecomaps and a sub-set of demographic data for this purposeful sample from the survey conducted in the quantitative study component. Qualitative data were analyzed using both conventional content analysis and reflexive thematic analysis; the subset of survey data extracted for these 29 participants were analyzed using descriptive statistics. Results Young mothers identified the need to have at least one individual, either an informal social support or formal service provider who they could talk to about their mental health. Among participants deciding to seek professional mental health support, their hesitancy to access services was grounded in past negative experiences or fears of being judged, being medicated, not being seen as an active partner in care decisions or experiencing increased child protection involvement. Participants identified organizational and provider attributes of those delivering mental health care that they perceived influenced their use of or engagement with services. Conclusion Organizations or health/social care professionals providing mental health services to young pregnant or parenting mothers are recommended to implement trauma-and violence-informed care. This approach prioritizes the emotional and physical safety of individuals within the care environment. Applying this lens in service delivery also aligns with the needs of young mothers, including that they are actively listened to, treated with respect, and genuinely engaged as active partners in making decisions about their care and treatment.

Exploring the Landscape of Eco-Mapping in Health Services Research: A Comprehensive Review

“…Ecomaps were used successfully to support data collection in the context of social networks and relationships for a range of populations [17,63,68,87]. We observed how eco-maps supported deep exploration and organization fndings during the interview process [21,51,53,54,57,67,68,80,92,93,97] and triangulate multiple data sources to reinforce data comprehensiveness (i.e., photos, text, and observations) [17,63,90]. In line with data visualization, some authors also referred to eco-maps ability to "synthesize" the data for greater visual impact [44].…”

“…Nurses and allied healthcare providers were often suggested to be well-positioned to assess family situations using ecomaps to establish appropriate interventions to support care [47,75,76,91,94]. Other authors used eco-mapping to "measure social support" of family members and individuals in the wider context in which they exist [63,99].…”

“…For example, authors Joubert et al [64] described a coding process presenting salient themes at each eco-map level. Te most commonly reported analytical techniques were thematic analysis [18,46,53,57,59,78,81,86], content analysis [49,50,63,65,92,93,[100][101][102][103], thematic content analysis [56,60,68,70,79,84], and an inductive or a "general inductive analysis approach" [58,77,91]. Several studies reported applying a theoretical framework (i.e., systems theory and thematic network analysis model) to the analysis process to identify sources of support deductively [52,64,72,76,90,95].…”

“…Several studies reported applying a theoretical framework (i.e., systems theory and thematic network analysis model) to the analysis process to identify sources of support deductively [52,64,72,76,90,95]. Some studies referred to discourse analysis [48,69,83], corpus reading [51], narrative analysis [54], interpretive analysis [71], the Method of Interpretation of the Senses [74], an approach based on "assumptions of qualitative feld research" [104], refexive thematic analysis [63], framework analysis [96], and a combination of deductive and inductive approaches to analysis [67].…”

A Comprehensive Review of Motherhood and Mental Health: Postpartum Mood Disorders in Focus

“…The non-judgmental and empathetic environment they foster encourages mothers to seek help without stigma. This therapeutic alliance between mental health professionals and mothers ensures that emotional struggles are met with understanding and that appropriate strategies for managing and overcoming these challenges are implemented [ 32 ].…”