“There is always a waitlist”: The experiences of perinatal women randomized to a waitlist condition in a trial evaluating a novel online self-directed intervention for perinatal anxiety

Abstract

BackgroundPregnant and postpartum women are at a heightened risk for the development or worsening of mental health problems, with elevated rates of mood and anxiety disorders noted across studies. Timely access to mental health supports is critical during the perinatal period (spanning pregnancy to 1 year postpartum), to mitigate potential negative impacts on mother and child. In general adult populations, a small body of research has highlighted the association between being waitlisted for mental health services with a deterioration in mental health. Given the influx of changes experienced in the perinatal period, this population may face unique challenges around being waitlisted. There is a lack of research exploring the experiences of perinatal women waitlisted for psychological services. The current study seeks to understand the experiences of perinatal women randomized to the waitlist condition of a randomized controlled trial.MethodsN = 20 participants (4 pregnant, 16 postpartum) from Central Canada who were enrolled in a novel online self-directed intervention for perinatal anxiety completed a virtual qualitative interview concerning their experience during the 6-week waitlist period for this randomized controlled trial. Interviews were audio-recorded, transcribed, and analyzed according to reflexive thematic analysis.ResultsSeven main themes were identified, depicting the waitlist experiences of perinatal participants: (a) “There is always a waitlist” (sub-themes: service availability, need to seek out services pre-emptively); (b) Timing of support access is vital during the perinatal period (sub-themes: prenatal, postpartum); (c) Responses to being waitlisted (sub-themes: disappointment, neutral, relief, “there's probably somebody that needs it more than I do”); (d) Identification of helpful supports during the waitlist period (sub-themes: formal supports, informal supports); (e) Connections with research team (sub-themes: communication, resource provision); (f) Impact of waitlist experience on desire to start program (sub-themes: excitement, “out of sight, out of mind,” nervousness); and (g) Improving the waitlist experience (sub-themes: communication, resource provision, triaging).DiscussionFindings highlight the need for timely access to mental health supports during the perinatal period and offer several recommendations for improving the waitlist experience, including providing more frequent waitlist status updates, providing more direct access to intermediate interventions, and triaging patients based on clinical need.

“I needed the help. They weren’t giving it”: Experiences of young people in tertiary education on waitlists for mental health services in Aotearoa

“…Across the literature, responses to being placed on a waitlist or being made to wait for treatment varied. Experiences of disappointment and frustration were described in multiple studies (Biringer et al, 2017;Kristjanson et al, 2022;Punton et al, 2022); however, this appeared to be more or less prominent depending on how distressed individuals felt when they were referred (Kristjanson et al, 2022). For example, Dowell et al (2021) conducted surveys and interviews with service users of Piki, a free primary mental health service piloted in Greater Wellington that provides psychological support to 18-25-year-olds experiencing mild to moderate mental distress as part of an evaluative report of the project.…”

“…Similarly, Kristjanson et al (2022) interviewed perinatal women with self-reported symptoms of anxiety about their experiences on a waitlist condition for an online intervention in cognitive behavioural therapy. Although many participants expressed disappointment at being waitlisted, some also described feeling relieved that they were on the list to receive support and grateful they would be able to participate in the therapy eventually.…”