City Research Online

Abstract

BACKGROUND: The experience of pregnancy and having a baby is a time of significant change and transition. One in five perinatal women experience problems with their emotional wellbeing and mental health in this period; adjustment, anxiety and depressive illnesses being most common. Whilst investment in specialist perinatal mental health pathways continues, there is limited understanding of healthcare professionals' views and experiences of these pathways and of support available for women with mild or moderate mental health problems. This study explored healthcare professionals' views on the barriers and facilitators to identification and management of perinatal anxiety, and on how to optimise care pathways.

METHODS: In-depth semi-structured interviews were conducted with a purposive sample of healthcare professionals in universal perinatal services (including maternity, primary care, and health-visiting) and specialist (including talking therapies, maternal and perinatal) mental health services. Data were analysed using framework analysis.

RESULTS: Interviews were conducted with 62 healthcare professionals from England and Scotland. 40% of the sample stated they had received no training in perinatal mental health, and 45% reported that they did not use standardised or validated questions or scales when enquiring about mental health. Themes related to barriers, facilitators, and service optimisation are presented for each stage of their care pathway: identification; disclosure; referral and assessment; care and treatment. Recommendations for optimising care included improving mental health education and training to strengthen perinatal healthcare and developing a sustainable perinatal mental health pathway, including for women with mild mental health problems.

CONCLUSIONS: Healthcare professionals considered that the healthcare pathway for women with severe mental health problems was clear and well-developed, but that healthcare for women with mild and moderate anxiety and mental health problems was under-developed. Improvements in perinatal mental health education, in mandatory training for healthcare professionals, should be put in place in order to improve care. Increasing the number of staff and time available to address perinatal mental health is vital but requires additional resources and should be part of long-term strategies for funding.

Publication Type:	Article
Additional Information:	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Publisher Keywords:	Assessment, Barriers and facilitators, Care pathway, Healthcare professionals, Perinatal anxiety, Training, Treatment
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RG Gynecology and obstetrics
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:	Symplectic Administrator

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