Engagement with perinatal mental health services: a cross-sectional questionnaire survey

Abstract

Background Perinatal depression and/or anxiety disorders are undertreated pregnancy complications. This is partly due to low rates of engagement by women. This study aimed to identify barriers and facilitators to women accessing perinatal mental health services in an outer metropolitan hospital in Queensland, Australia. Methods Data was collected from pregnant women through a cross-sectional survey. Women rated the extent certain factors influenced their engagement. Respondents were separated into three groups: women who were not offered a referral to perinatal mental health services, women who were offered a referral but did not engage, and women who engaged. Results A total of 218 women participated. A response rate of 71% was achieved. 38.1% of participants did not believe themselves knowledgeable about mental illness in the perinatal period, and 14.7% did not recall being asked about their mental health during their pregnancy. Of those participants who recalled being asked about their mental health, 37.1% were offered a referral. Of these, just over a third (36.2%) accepted, and out of this group, 40% attended an appointment. Regardless of referral and engagement status, the factors identified as influencing participant engagement were time restraints, lack of childcare support, and encouragement by family and health care professionals. Stigma was not identified as a barrier. Conclusions Perinatal mental health service engagement could be improved by health services: ensuring universal screening and actively engaging women in the process: assisting with childcare; improving appointment immediacy and accessibility; and educating health care professionals about their influence on women’s engagement. Electronic supplementary material The online version of this article (10.1186/s12884-019-2320-9) contains supplementary material, which is available to authorized users.

Provision of obstetrics and gynaecology services during the COVID‐19 pandemic: a survey of junior doctors in the UK National Health Service

“…Reducing face-to-face antenatal appointments could increase pregnancy complications in high-risk groups such as victims of domestic violence, deprived populations with limited access to advanced technology and those with mental health issues. 28,29 As with every new endeavour, efficient data collection and analysis are essential elements to advise our response to this global pandemic. Our findings shed some light on the impact of COVID-19 on obstetrics and gynaecology healthcare services in the UK, but more stringent long-term data collection and sharing are needed to fully evaluate the impact of this pandemic on women's health outcomes and to coordinate a global response to eliminate it.…”

Prescribing antidepressants and anxiolytic medications to pregnant women: Comparing perception of risk of foetal teratogenicity between Australian Obstetricians and Gynaecologists, Speciality trainees and upskilled General Practitioners

“…Considerable uncertainty in prescribing AD and AX in pregnancy exists, even amongst clinicians with expertise in antenatal health care provision [2,9,11]. Women in general also express extreme reluctance to take medication in pregnancy [7,8,17]. Both clinician groups in this study felt that training had not been adequate to instil con dence in medication prescription, even though many health professionals had trained for more than ten years.…”

“…Pregnant women with antenatal anxiety and depression are less likely to attend regular antenatal appointments and have higher complications such as stillbirth, premature birth, low birth weight and low Apgar scores [3,15,16]. Engagement of pregnant women with perinatal mental health services remains an everlasting challenge with the added concern of patient initiated sudden cessation of medication [17]. Hence, clinician's con dence and competence in adequately treating anxiety and depression in pregnancy is very important.…”

Prescribing antidepressants and anxiolytic medications to pregnant women: comparing perception of risk of foetal teratogenicity between Australian Obstetricians and Gynaecologists, Speciality Trainees and upskilled General Practitioners

“…Pregnant women with antenatal anxiety and depression are less likely to attend regular antenatal appointments and have higher complications such as stillbirth, premature birth, low birth weight and low Apgar scores [3,15,16]. Engagement of pregnant women with perinatal mental health services remains an everlasting challenge with the added concern of patient initiated sudden cessation of medication [17]. Hence, clinician's confidence and competence in adequately treating anxiety and depression in pregnancy is very important.…”