Proof-of-Concept Support for the Development and Implementation of a Digital Assessment for Perinatal Mental Health: Mixed Methods Study

Abstract

Background Perinatal mental health symptoms commonly remain underdiagnosed and undertreated in maternity care settings in the United Kingdom, with outbreaks of disease, like the COVID-19 pandemic, further disrupting access to adequate mental health support. Digital technologies may offer an innovative way to support the mental health needs of women and their families throughout the perinatal period, as well as assist midwives in the recognition of perinatal mental health concerns. However, little is known about the acceptability and perceived benefits and barriers to using such technologies. Objective The aim of this study was to conduct a mixed methods evaluation of the current state of perinatal mental health care provision in the United Kingdom, as well as users’ (women and partners) and midwives’ interest in using a digital mental health assessment throughout the perinatal period. Methods Women, partners, and midwives were recruited to participate in the study, which entailed completing an online survey. Quantitative data were explored using descriptive statistics. Open-ended response data were first investigated using thematic analysis. Resultant themes were then mapped onto the components of the Capability, Opportunity, and Motivation Behavior model and summarized using descriptive statistics. Results A total of 829 women, 103 partners, and 90 midwives participated in the study. The provision of adequate perinatal mental health care support was limited, with experiences varying significantly across respondents. There was a strong interest in using a digital mental health assessment to screen, diagnose, and triage perinatal mental health concerns, particularly among women and midwives. The majority of respondents (n=781, 76.42%) expressed that they would feel comfortable or very comfortable using or recommending a digital mental health assessment. The majority of women and partners showed a preference for in-person consultations (n=417, 44.74%), followed by a blended care approach (ie, both in-person and online consultations) (n=362, 38.84%), with fewer participants preferring online-only consultations (n=120, 12.88%). Identified benefits and barriers mainly related to physical opportunity (eg, accessibility), psychological capability (eg, cognitive skills), and automatic motivation (eg, emotions). Conclusions This study provides proof-of-concept support for the development and implementation of a digital mental health assessment to inform clinical decision making in the assessment of perinatal mental health concerns in the United Kingdom.

mHealth Solutions for Perinatal Mental Health: Scoping Review and Appraisal Following the mHealth Index and Navigation Database Framework

“…Immediacy, accessibility, and affordability are among the potential benefits of using digital tools to identify perinatal mental health concerns. In the field of perinatal mental health, recent studies have highlighted that new mothers and those with postnatal depression are interested in using health apps [23], and recent studies have highlighted a growing research effort in the implementation of mHealth tools for psychoeducation and prevention of perinatal mental health concerns [24][25][26]. The COVID-19 pandemic has fueled interest in digital mental health solutions, as elevated levels of stress coupled with reduced in-person care prompted changes in mental health care provisions [26,27].…”

Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis

“…In this regard, particularly nurses and midwives play an important role. Clinic evaluation, counseling, and early intervention by the right health professional can accelerate recovery from mental health problems and increase psychological well-being (Coates & Foureur, 2019; Halcomb et al, 2019; Martin-Key et al, 2021).…”

Learnings from user feedback of a novel digital mental health assessment

“…This has prompted research into reasons for poor user engagement. User attitudes toward and perspectives of digital mental health tools have been investigated via interviews and focus groups (45)(46)(47)(48)(49), surveys (50)(51)(52)(53), and app user reviews studies (54)(55)(56)(57)(58). In a systematic review of 208 studies investigating user engagement with DMHIs, three constructs of engagement factors were identified related to: (1) the user, (2) the program, and (3) the technology and environment (59).…”