Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare
<p>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.</p> <p><strong>Objectives</strong> To synthesise the...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023
|
| _version_ | 1826311081430089728 |
|---|---|
| author | 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 |
| author2 | MATRIx Study Team |
| author_facet | 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 |
| author_sort | Webb, R |
| collection | OXFORD |
| description | <p>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.</p>
<p><strong>Objectives</strong> 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.</p>
<p><strong>Design</strong> A meta-review of systematic reviews.</p>
<p><strong>Review methods</strong> 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.</p>
<p><strong>Results</strong> 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.</p>
<p><strong>Conclusion</strong> 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.</p>
<p><strong>PROSPERO registration number</strong> CRD42019142854.</p> |
| first_indexed | 2024-03-07T08:03:06Z |
| format | Journal article |
| id | oxford-uuid:1493f78d-480c-42fc-8733-4669e43b30fa |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:03:06Z |
| publishDate | 2023 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:1493f78d-480c-42fc-8733-4669e43b30fa2023-10-12T17:25:29ZMeta-review of the barriers and facilitators to women accessing perinatal mental healthcareJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1493f78d-480c-42fc-8733-4669e43b30faEnglishSymplectic ElementsBMJ Publishing Group2023Webb, RUddin, NConstantinou, GFord, EEaster, AShakespeare, JHann, ARoberts, NAlderdice, FSinesi, ACoates, RHogg, SAyers, SMATRIx Study Team<p>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.</p> <p><strong>Objectives</strong> 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.</p> <p><strong>Design</strong> A meta-review of systematic reviews.</p> <p><strong>Review methods</strong> 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.</p> <p><strong>Results</strong> 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.</p> <p><strong>Conclusion</strong> 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.</p> <p><strong>PROSPERO registration number</strong> CRD42019142854.</p> |
| spellingShingle | 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 Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare |
| title | Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare |
| title_full | Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare |
| title_fullStr | Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare |
| title_full_unstemmed | Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare |
| title_short | Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare |
| title_sort | meta review of the barriers and facilitators to women accessing perinatal mental healthcare |
| work_keys_str_mv | AT webbr metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT uddinn metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT constantinoug metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT forde metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT eastera metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT shakespearej metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT hanna metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT robertsn metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT alderdicef metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT sinesia metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT coatesr metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT hoggs metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare AT ayerss metareviewofthebarriersandfacilitatorstowomenaccessingperinatalmentalhealthcare |