Mothers’ experiences of acute perinatal mental health services in England and Wales: a qualitative analysis

ABSTRACT

Background/Objective

Perinatal mental health services are a current NHS priority and services are being increased for women. There is limited research on mothers’ perspectives of these services and most research focuses on mother and baby units (MBUs). This study explored women’s views of their experiences of generic wards, MBUs and crisis resolution teams.

Methods

A qualitative thematic analysis was conducted on written feedback on a service-user-designed questionnaire. One hundred and thirty-nine women recruited across 42 mental health trusts made comments.

Results

Two key themes were identified: support networks and staff authority. Support networks included subthemes relating to families, peers and staff. The theme of staff authority incorporated subthemes about communication, confidence in staff and service-user autonomy. All themes contributed to whether mothers felt safe in these services. Mothers reported the benefits of positive, non-coercive relationships with family and staff for their recovery. The findings highlight that the challenges women face in perinatal settings reflect the literature on general psychiatric services, particularly around coercion.

Conclusions

Specific implications for mothers accessing perinatal mental health services: 1) integrated mental health care and support with babies; 2) support with separation from babies for mothers in acute wards; 3) improvement of women’s relationships with social services across all services.

KEYWORDS:

• Perinatal
• mental health
• psychiatric services
• mothers
• qualitative

Disclosure statement

LMH chaired the NICE CG192 guidelines development group on antenatal and postnatal mental health in 2012-2014..

Additional information

Funding

This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (PGfAR) Programme (Grant Reference Number: RP-PG-1210-12002) and the National Institute for Health Research (NIHR)/Wellcome Trust King’s and Manchester Clinical Research Facility. The study team acknowledges the study delivery support given by the national NIHR Clinical Research Networks. This study represents independent research supported by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. LMH is also supported by an NIHR Research Professorship (NIHR-RP-R3-12-011). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.