Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa

Background: Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child. Aim: The study aimed to e...

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Main Authors: Sally Field, Zulfa Abrahams, Simone Honikman
Format: Article
Language:English
Published: AOSIS 2020-05-01
Series:African Journal of Primary Health Care & Family Medicine
Subjects:
Online Access:https://phcfm.org/index.php/phcfm/article/view/2279
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author Sally Field
Zulfa Abrahams
Simone Honikman
author_facet Sally Field
Zulfa Abrahams
Simone Honikman
author_sort Sally Field
collection DOAJ
description Background: Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child. Aim: The study aimed to explore the barriers and facilitators to service access for adolescents in low-resource settings. Setting: We interviewed 12 adolescents, aged 15–19 years, from low-resource settings in Cape Town, South Africa. Participants had previously engaged with a mental health service, integrated into maternity care. Methods: Twelve semi-structured, individual interviews were used for this qualitative study. Interviews were recorded, transcribed and coded. A framework analysis was employed for data analysis. Results: Adolescents perceived considerable stigma around both teenage pregnancy and mental illness, which inhibited use of mental health services. Other barriers included fearing a lack of confidentiality as well as logistical and environmental obstacles. Service uptake was facilitated by support from other adults and flexible appointment times. Face-to-face individual counselling was their preferred format for a mental health intervention. Conclusion: Several key components for adolescent-friendly mental health services emerged from our findings: integrate routine mental health screening into existing obstetric services to de-stigmatise mental health problems and optimise screening coverage; coordinate obstetric and counselling appointment times to rationalise the use of limited resources; and sensitise care providers to the needs of adolescents to reduce stigma around adolescent sexual activity and mental illness. A non-judgemental, caring and confidential relationship between counsellors and clients is crucial for successful interactions.
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spelling doaj.art-f6c21558662c498bbb6d9adb5951be492022-12-22T00:36:35ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362020-05-01121e1e910.4102/phcfm.v12i1.2279718Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South AfricaSally Field0Zulfa Abrahams1Simone Honikman2Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape TownPerinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape TownPerinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape TownBackground: Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child. Aim: The study aimed to explore the barriers and facilitators to service access for adolescents in low-resource settings. Setting: We interviewed 12 adolescents, aged 15–19 years, from low-resource settings in Cape Town, South Africa. Participants had previously engaged with a mental health service, integrated into maternity care. Methods: Twelve semi-structured, individual interviews were used for this qualitative study. Interviews were recorded, transcribed and coded. A framework analysis was employed for data analysis. Results: Adolescents perceived considerable stigma around both teenage pregnancy and mental illness, which inhibited use of mental health services. Other barriers included fearing a lack of confidentiality as well as logistical and environmental obstacles. Service uptake was facilitated by support from other adults and flexible appointment times. Face-to-face individual counselling was their preferred format for a mental health intervention. Conclusion: Several key components for adolescent-friendly mental health services emerged from our findings: integrate routine mental health screening into existing obstetric services to de-stigmatise mental health problems and optimise screening coverage; coordinate obstetric and counselling appointment times to rationalise the use of limited resources; and sensitise care providers to the needs of adolescents to reduce stigma around adolescent sexual activity and mental illness. A non-judgemental, caring and confidential relationship between counsellors and clients is crucial for successful interactions.https://phcfm.org/index.php/phcfm/article/view/2279adolescentsmaternal mental healthservice uptakebarriers to carefacilitators to carequalitativedepressionanxiety
spellingShingle Sally Field
Zulfa Abrahams
Simone Honikman
Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa
African Journal of Primary Health Care & Family Medicine
adolescents
maternal mental health
service uptake
barriers to care
facilitators to care
qualitative
depression
anxiety
title Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa
title_full Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa
title_fullStr Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa
title_full_unstemmed Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa
title_short Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa
title_sort adolescent mothers a qualitative study on barriers and facilitators to mental health in a low resource setting in cape town south africa
topic adolescents
maternal mental health
service uptake
barriers to care
facilitators to care
qualitative
depression
anxiety
url https://phcfm.org/index.php/phcfm/article/view/2279
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AT simonehonikman adolescentmothersaqualitativestudyonbarriersandfacilitatorstomentalhealthinalowresourcesettingincapetownsouthafrica