A qualitative investigation of models of community mental health care for women with perinatal mental health problems

Abstract

Background

Specialist community perinatal mental health teams support women diagnosed with moderate to severe psychiatric difficulties in pregnancy or postnatally. These teams are being expanded across the UK, and there is considerable international interest in this model of care. However, not all women access these teams, and many are instead supported by community mental health services that do not specialise in the perinatal period.

Aims

To explore perinatal women’s experiences of specialist perinatal versus generic non-perinatal community mental health support.

Methods

Semi-structured interviews were conducted with 36 women diagnosed with perinatal mental health difficulties who were supported in the community either by a specialist perinatal or general non-perinatal mental health service. Data were analysed thematically.

Results

Women felt that specialist perinatal and non-perinatal services alike were under-resourced and somewhat too narrow in their remit, but reported positive experiences across both settings. They particularly valued the specialist expertise offered by perinatal teams, but also valued greater continuity of care over a longer period, which some non-perinatal teams provided.

Conclusions

The findings suggest that women who experience perinatal mental health difficulties value specialist perinatal expertise, but that general, non-perinatal teams may also have advantages for some. Further research into optimal care arrangements is merited.

Keywords:

• Community
• mental health
• perinatal
• services
• women

Acknowledgements

The authors are very grateful indeed for the advice and support received from the Perinatal Service User and Carer Advisory Group, and from the wider ESMI study team. The study team would also like to thank the women who gave up their time to take part in the study.

Ethics approval

All procedures contributing to this work complied with the ethical standards of the English National Health Service. Ethical approval was obtained from the Camberwell St Giles London Research Ethics Committee (REC reference: 13/LO/1855). Informed written consent was obtained from all individual participants included in the study.

Disclosure statement

The authors declare that they have no competing interests.

Data availability statement

The datasets generated and/or analysed during the current study are not publicly available due to them containing information that could compromise research participant privacy/consent but are available from the corresponding author on reasonable request.

Notes

1 One additional interview was accidentally not recorded and was therefore excluded.

2 Mothers were given ID codes (1-36) and verbatim comments are labelled using these.

Additional information

Funding

This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (PGfAR) Programme (Grant Reference Number RP-PG-1210-12002). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The study team acknowledges the study delivery support given by the local Clinical Research Networks. SJ is supported by the NIHR Mental Health Research Policy Unit, the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames and the UCLH Biomedical Research Centre. LMH was supported by a National Institute for Health Research (NIHR) Research Professorship (NIHR-RP-R32-011). She is now partly supported by the South London and Maudsley NHS Foundation Trust/King’s College London Biomedical Research Centre.