Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare

MATRIx Study Team; Rebecca Webb; Nazihah Uddin; Georgina Constantinou; Elizabeth Ford; Abigail Easter; Judy Shakespeare; Agnes Hann; Nia Roberts; Fiona Alderdice; Andrea Sinesi; Rose Coates; Sally Hogg; Susan Ayers

doi:10.1136/bmjopen-2022-066703

Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare

MATRIx Study Team, Rebecca Webb, Nazihah Uddin, Georgina Constantinou, Elizabeth Ford, Abigail Easter, Judy Shakespeare, Agnes Hann, Nia Roberts, Fiona Alderdice, Andrea Sinesi, Rose Coates, Sally Hogg, Susan Ayers

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care. Objectives To synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy. Design A meta-review of systematic reviews. Review methods Seven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating. Results A total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators. Conclusion The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO registration number CRD42019142854.

Original language	English
Article number	e066703
Pages (from-to)	e066703
Journal	BMJ Open
Volume	13
Issue number	7
Early online date	20 Jul 2023
DOIs	https://doi.org/10.1136/bmjopen-2022-066703
Publication status	E-pub ahead of print - 20 Jul 2023

Keywords

Female
Humans
Pregnancy
Health Personnel/psychology
Mental Health
Mental Health Services
Parturition
Systematic Reviews as Topic

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/bmjopen-2022-066703Licence: CC BY

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MATRIx Study Team, Webb, R., Uddin, N., Constantinou, G., Ford, E., Easter, A., Shakespeare, J., Hann, A., Roberts, N., Alderdice, F., Sinesi, A., Coates, R., Hogg, S., & Ayers, S. (2023). Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare. BMJ Open, 13(7), e066703. Article e066703. Advance online publication. https://doi.org/10.1136/bmjopen-2022-066703

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title = "Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare",

abstract = "Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care. Objectives To synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy. Design A meta-review of systematic reviews. Review methods Seven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating. Results A total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators. Conclusion The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO registration number CRD42019142854.",

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AU - MATRIx Study Team

AU - Webb, Rebecca

AU - Uddin, Nazihah

AU - Constantinou, Georgina

AU - Ford, Elizabeth

AU - Easter, Abigail

AU - Shakespeare, Judy

AU - Hann, Agnes

AU - Roberts, Nia

AU - Alderdice, Fiona

AU - Sinesi, Andrea

AU - Coates, Rose

AU - Hogg, Sally

AU - Ayers, Susan

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

PY - 2023/7/20

Y1 - 2023/7/20

N2 - Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care. Objectives To synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy. Design A meta-review of systematic reviews. Review methods Seven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating. Results A total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators. Conclusion The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO registration number CRD42019142854.

AB - Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care. Objectives To synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy. Design A meta-review of systematic reviews. Review methods Seven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating. Results A total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators. Conclusion The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO registration number CRD42019142854.

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KW - Humans

KW - Pregnancy

KW - Health Personnel/psychology

KW - Mental Health

KW - Mental Health Services

KW - Parturition

KW - Systematic Reviews as Topic

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DO - 10.1136/bmjopen-2022-066703

M3 - Article

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SN - 2044-6055

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JO - BMJ Open

JF - BMJ Open

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ER -

Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare

Abstract

Keywords

UN SDGs

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