References

Anderson FM, Hatch SL, Comacchio C, Howard LM. Prevalence and risk of mental disorders in the perinatal period among migrant women: a systematic review and meta-analysis. Arch Women Ment Health. 2017; 20:(3)449-462 https://doi.org/10.1007/s00737-017-0723-z

Bates L, Stickley T. Confronting Goffman: how can mental health nurses effectively challenge stigma? A critical review of the literature. J Psychiatr Ment Health Nurs. 2013; 20:(7)569-575 https://doi.org/10.1111/j.1365-2850.2012.01957.x

Brown G, Marshall M, Bower P, Woodham A, Waheed W. Barriers to recruiting ethnic minorities to mental health research: a systematic review. Int J Methods Psychiatr Res. 2014; 23:(1)36-48 https://doi.org/10.1002/mpr.1434

Bolton HL, Hughes PM, Turton P, Sedgwick P. Incidence and demographic correlates of depressive symptoms during pregnancy in an inner London population. J Psychosom Obstet Gynaecol. 1998; 19:(4)202-209 https://doi.org/10.3109/01674829809025698

Clement S, Schauman O, Graham T What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015; 45:(1)11-27 https://doi.org/10.1017/S0033291714000129

Dennis CL, Chung-Lee L. Postpartum depression help-seeking barriers and maternal treatment preferences: a qualitative systematic review. Birth. 2006; 33:(4)323-331 https://doi.org/10.1111/j.1523-536X.2006.00130.x

Department of Health. Delivering Race Equality in Mental Health Care: A Summary. 2009. http://www.milesfrance.co.uk/wp-content/uploads/resources/national-documents/DH,2009-DeliveringRaceEqualityinMHCare_AReview.pdf (accessed 17 Sept 2019)

Edge D, MacKian SC. Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK. Ethn Health. 2010; 15:(1)93-111 https://doi.org/10.1080/13557850903418836

Edge D. ‘It's leaflet, leaflet, leaflet then, “see you later”’: black Caribbean women's perceptions of perinatal mental health care. Br J Gen Pract. 2011; 61:(585)256-262 https://doi.org/10.3399/bjgp11X567063

Gardner PL, Bunton P, Edge D, Wittkowski A. The experience of postnatal depression in West African mothers living in the United Kingdom: A qualitative study. Midwifery. 2014; 30:(6)756-763 https://doi.org/10.1016/j.midw.2013.08.001

Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet. 2014; 384:(9956)1775-1788 https://doi.org/10.1016/S0140-6736(14)61276-9

Jones I, Chandra PS, Dazzan P, Howard LM. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet. 2014; 384:(9956)1789-99 https://doi.org/10.1016/S0140-6736(14)61278-2

Karlsen S, Nazroo J, McKenzie K, Bhui K, Weich S. Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychol Med. 2005; 35:(12)1795-1803 https://doi.org/10.1017/S0033291705005830

King L, Pestell S, Farrar S, North N, Brunt C. Screening for antenatal psychological distress. Br J Midwifery. 2013; 20:(6)396-401 https://doi.org/10.12968/bjom.2012.20.6.396

Kingston D, Tough S, Whitfield H. Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiatry Hum Dev. 2012; 43:(5)683-714 https://doi.org/10.1007/s10578-012-0291–4

Saving Lives, Improving Mothers' Care - Surveillance of maternal deaths in the UK 2012-14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-14. 2016. https://www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202016%20-%20website.pdf (accessed 10 September 2019)

The maternal mental health of migrant women. 2014. https://www.gmmh.nhs.uk/download.cfm?doc=docm93jijm4n895.pdf&ver=1674 (accessed 10 September 2019)

Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001; 27:(1)363-385 https://doi.org/10.1146/annurev.soc.27.1.363

McLeish J. Maternity experiences of asylum seekers in England. Br J Midwifery. 2005; 13:(12)782-785 https://doi.org/10.12968/bjom.2005.13.12.20125

Megnin-Viggars O, Symington I, Howard LM, Pilling S. Experience of care for mental health problems in the antenatal or postnatal period for women in the UK: a systematic review and meta-synthesis of qualitative research. Arch Women Ment Health. 2015; 18:(6)745-759 https://doi.org/10.1007/s00737-015-0548–6

Myers S, Johns SE. Postnatal depression is associated with detrimental life-long and multi-generational impacts on relationship quality. PeerJ. 2018; 6:(6) https://doi.org/10.7717/peerj.4305

NHS England. Specialised perinatal mental health services (in-patient mother and baby units and linked outreach teams). Service specifications. 2016a. https://www.england.nhs.uk/wp-content/uploads/2016/12/c06-spec-peri-mh.pdf (accessed 10 September 2019)

NHS England. Better Births: Improving outcomes of maternity services in England. 2016b. https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf (accessed 10 September 2019)

Noonan M, Doody O, Jomeen J, Galvin R. Midwives' perceptions and experiences of caring for women who experience perinatal mental health problems: an integrative review. Midwifery. 2017; 45:56-71 https://doi.org/10.1016/j.midw.2016.12.010

Onozawa K, Kumar RC, Adams D, Doré C, Glover V. High EPDS scores in women from ethnic minorities living in London. Arch Women Ment Health. 2003; 6:(2)S51-S55 https://doi.org/10.1007/s00737-003-0006-8

Parvin A, Jones CE, Hull SA. Experiences and understandings of social and emotional distress in the postnatal period among Bangladeshi women living in Tower Hamlets. Fam Pract. 2004; 21:(3)254-260 https://doi.org/10.1093/fampra/cmh307

Prady SL, Pickett KE, Gilbody S Variation and ethnic inequalities in treatment of common mental disorders before, during and after pregnancy: combined analysis of routine and research data in the Born in Bradford cohort. BMC Psychiatry. 2016; 16:(1) https://doi.org/10.1186/s12888-016-0805-x

Raymond JE. ‘Creating a safety net’: women's experiences of antenatal depression and their identification of helpful community support and services during pregnancy. Midwifery. 2009; 25:(1)39-49 https://doi.org/10.1016/j.midw.2007.01.005

Redshaw M, Henderson J. Who is actually asked about their mental health in pregnancy and the postnatal period? Findings from a national survey. BMC Psychiatry. 2016; 16:(1) https://doi.org/10.1186%2Fs12888-016-1029-9

Stein A, Pearson RM, Goodman SH Effects of perinatal mental disorders on the fetus and child. Lancet. 2014; 384:(9956)1800-1819 https://doi.org/10.1016/S0140-6736(14)61277-0

Templeton L, Velleman R, Persaud A, Milner P. The experiences of postnatal depression in women from black and minority ethnic communities in Wiltshire, UK. Ethn Health. 2010; 8:(3)207-221 https://doi.org/10.1080/1355785032000136425

The Mental Health Taskforce. The five year forward view for mental health. 2016. https://www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf (accessed 10 September 2019)

Thomson MS, Chaze F, George U, Guruge S. Improving Immigrant Populations' Access to Mental Health Services in Canada: A Review of Barriers and Recommendations. J Immigr Minor Health. 2015; 17:(6)1895-1905 https://doi.org/10.1007/s10903-015-0175-3

Tucker JR, Hammer JH, Vogel DL Disentangling self-stigma: are mental illness and help-seeking self-stigmas different?. J Couns Psychol. 2013; 60:(4)520-531 https://doi.org/10.1037/a0033555

Waheed W, Hughes-Morley A, Woodham A, Allen G, Bower P. Overcoming barriers to recruiting ethnic minorities to mental health research: a typology of recruitment strategies. BMC Psychiatry. 2015; 15:(1) https://doi.org/10.1186/s12888-015-0484-z

Wallace S, Nazroo J, Bécares L. Cumulative effect of racial discrimination on the mental health of ethnic minorities in the United Kingdom. Am J Public Health. 2016; 106:(7)1294-1300 https://doi.org/10.2105/AJPH.2016.303121

Watson HL, Harrop D, Walton E, Young A, Soltani H. A systematic review of ethnic minority women's experiences of perinatal mental health conditions and services in Europe. PLOSOne. 2019; 14:(1) https://doi.org/10.1371/journal.pone.0210587

Williams CJ, Turner KM, Burns A, Evans J, Bennert K Midwives and women's views on using UK recommended depression case finding questions in antenatal care. Midwifery. 2016; 35:39-46 https://doi.org/10.1016/j.midw.2016.01.015

Wittkowski A, Zumla A, Glendenning S, Fox JRE. The experience of postnatal depression in South Asian mothers living in Great Britain: a qualitative study. J Reprod Infant Psychol. 2011; 29:(5)480-492 https://doi.org/10.1080/02646838.2011.639014

Perinatal mental ill health: the experiences of women from ethnic minority groups

02 October 2019
Volume 27 · Issue 10

Abstract

Objectives

This study aimed to investigate ethnic minority women's experiences and opinions of perinatal mental health problems and the provision support services.

Methods

An exploratory survey was undertaken using a questionnaire. Quantitative data were analysed using descriptive statistics and a simple thematic analysis was used for the qualitative data. A total of 51 responses from women of 14 different ethnic minority backgrounds were analysed.

Findings

Women from minority ethnic groups face barriers to seeking help for perinatal mental ill health as a result of ongoing stigma, the poor attitudes and behaviours of health professionals and inappropriately designed services.

Conclusions

Future interventions should focus on providing adequate cultural competency for health professionals and ensure that all women are able to access culturally appropriate spaces to talk and be listened to in community settings and wider services.

Mental health disorders are among the most common morbidities experienced during the perinatal period (Megnin-Viggars et al, 2015). These disorders may be pre-existent or they may develop during the perinatal period. They include depression, anxiety, post-traumatic stress disorder, eating disorders, personality disorders, bipolar disorder, affective psychosis and schizophrenia (Howard et al, 2014; Jones et al, 2014).

Perinatal mental health is a significant risk factor for maternal mortality. Recent evidence suggests that 23% of women who died in the postnatal period suffered from mental health disorders, and suicide is now the second leading cause of maternal death in the UK (Knight et al, 2016). Adverse health and social experiences associated with perinatal mental health are not limited to mothers. They can also result in poor pregnancy outcomes including preterm birth, low birthweight and poor maternal-infant interaction, which is associated with child behavioural, emotional and cognitive problems and reduced educational attainment (Stein et al, 2014; Myers and Jones, 2018). Maternal mental ill health also has a devastating and long-lasting impact on families.' lives, as well as having considerable cost and resource implications for health services (Kingston et al, 2012; Howard et al, 2014; Prady et al, 2016; The Mental Health Taskforce, 2016).

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