Barriers to Accessing Perinatal Mental Health Services in Ethnic Minority Women in the UK

Abstract

Abstract Background Mental health problems are common among women during the perinatal period (here defined as during pregnancy and the 2 years after birth), affecting up to 20% of women. Although there are effective treatments for perinatal mental health problems, ethnic minority women who are at higher risk of developing perinatal mental health problems are less likely to access treatment for their perinatal mental health problems. This study explored perceptions of perinatal mental health problems and barriers to accessing treatment amongst a sample of ethnic minority women with current or past experiences who did not receive help from a specialist team. Methods This study is qualitative primary research. Twenty-eight women living in England who reported they struggled with emotional and mental health challenges during their perinatal period but did not receive assistance from the specialist perinatal mental health team were recruited from community groups and adverts. Women participated in online interviews, which were transcribed. NVIVO was used to support a thematic analysis. Results Barriers to accessing perinatal mental health services were found at the individual and cultural levels and at the point of accessibility. Barriers at ethnic levels influenced women’s decision to seek help and the time at which the help would be sought. The identified barriers were grouped under three main themes: Cultural beliefs and expectations (including those based on previous discriminatory experiences of healthcare), Help-seeking patterns and accessibility barriers (included in this theme is the reluctance of health professionals in signposting women to perinatal mental health service in an attempt to cover up medical negligence or error). Conclusion Cultural beliefs and perceptions of perinatal mental health, expectations of motherhood and barriers associated with accessibility were the primary barriers to accessing perinatal mental health services. While accessibility barriers were generally prevalent, women from minority ethnic groups may face additional barriers due to their cultural attitudes towards mental health and prior discriminatory experiences of mental health services, and influences towards seeking assistance.