Barriers to addressing perinatal mental health issues in midwifery settings

The role and competence of midwives in supporting women with mental health concerns during the perinatal period: A scoping review

“…The review process identified 30 papers that met inclusion criteria (see Table ). Included studies regard the knowledge, skills and attitudes of midwives (Hauck et al., ; Higgins et al., ; Jones, Creedy, & Gamble, , ,; Lau, McCauley, Barnfield, Moss, & Cross, ; Legere et al., ; Mathibe‐Neke, Rothberg, & Langley, ; McCauley et al., ; Noonan, Doody, Jomeen, & Galvin, ; Noonan et al., ; Ross‐Davie, Elliott, Sarkar, & Green, ; Rothera & Oates, ), and student midwives (Higgins, Carroll, & Sharek, ; Jarrett, , ; Phillips, ); the effectiveness of educational interventions in improving knowledge and skills (Davies et al., ; Fenwick, Toohill, Slavin, Creedy, & Gamble, ; McLachlan, Forster, Collins, Gunn, & Hegarty, ; Reed, Fenwick, Hauck, Gamble, & Creedy, ); the delivery of counselling or psychosocial interventions by midwives (Clarke, King, & Prost, ; Fenwick et al., , ; Larsson, Karlström, Rubertsson, & Hildingsson, ; Toohill et al., ); and barriers and enablers to embedding midwife‐led mental healthcare in practice (Bayrampour et al., ; Fenwick et al., ; Gamble, Toohill, Slavin, Creedy, & Fenwick, ; Higgins et al., ; Myors, Schmied, Johnson, & Cleary, ; Myors et al., ).…”

“…Studies in relation to the delivery of counselling or psychosocial interventions by midwives include a systematic review and meta‐analysis of 10 randomised controlled trials (RCTs) (Clarke et al., ), a single RCT (published in two papers) (Fenwick et al., ; Toohill et al., ), a qualitative interview study (Fenwick et al., ) and a national survey study (Larsson et al., ). Studies that outline barriers and enablers to embedding midwife‐led mental healthcare (other than knowledge and skills deficits), include two integrative reviews (Bayrampour et al., ; Myors et al., ) and three mixed method studies (Fenwick et al., ; Gamble et al., ; Myors et al., ).…”

“…As outlined, a key barrier to the delivery of midwife‐led mental healthcare is a lack of access to training and education, and in turn limited mental health skills and knowledge reported by midwives (Bayrampour et al., ; Higgins et al., ; Legere et al., ; McCauley et al., ; Noonan et al., ; Ross‐Davie et al., ; Rothera & Oates, ). In addition to a lack of competence and confidence, midwives report a range of organisational barriers as hindering their ability to incorporate mental healthcare into their practice, specifically heavy workload, lack of time, lack of privacy, not seeing women frequently enough and conflicts with organisational priorities (Bayrampour et al., ; Gamble et al., ; Higgins et al., ; Jones et al., ). A study by Fenwick et al.…”

“…Another reason women fall between the gap of maternity and specialist mental health services is because of the lag time between the antenatal screening process and being contacted by a mental health clinician (Myors, Johnson, Cleary, & Schmied, ). While screening is effective at identifying women at risk of poor perinatal mental health outcomes, the current service system is fragmented (Bayrampour, Hapsari, & Pavlovic, ) and women report that their mental health needs are mostly left unaddressed (Royal College of Obstetricians and Gynaecologists, ).…”

Public health nurses’ perinatal mental health training needs: A cross sectional survey

“…Healthcare professional's knowledge of risk and protective factors associated with PMHPs influences the sensitive inquiry process during consultations with women and their families (Galloway & Hogg, 2015). Moreover, a lack of knowledge of risk factors has been identified as a barrier to screening (Bayrampour, Hapsari, & Pavlovic, 2018). Jomeen, Martin, et al (2018b) The MICA 4 scale is applicable to a variety of healthcare professionals with a higher score suggesting more negative stigma-associated attitudes to mental health (Gabbidon et al, 2013).…”