Health professionals’ views of perinatal mental healthcare for Black and minority ethnic (BME) women

Objectives: To investigate health professionals’ views about perinatal mentalhealthcare for Black and minority ethnic (BME) women with specific reference toanecdotally low levels of consultation by Black Caribbean women.Methods: Qualitative data were collected via individual interviews and focus groupsamong a range of community and hospital-based healthcare professionals.Participants (n542) were recruited from antenatal community clinics, a largeteaching hospital, General Practice, and a specialist voluntary sector agency in thenorthwest of England, UK.Results: Participants reported inadequacies in training and lack of confidence notonly for identifying the specific needs of Black women but also for managingperinatal depression more generally – particularly in women with mild-to-moderateor ‘sub-threshold’ depression. Failure to screen routinely, confusion aboutprofessional roles and boundaries coupled with poorly defined care pathwaysincreased the likelihood of women ‘falling through the net’ thus failing to receiveappropriate care and treatment.Conclusions: Sub-optimal detection and treatment of perinatal depression, particularlyamong ‘high risk’ women, highlight gaps between current policy and practice. Whilstthese issues clearly affect women from all ethnic backgrounds, findings from this studysuggest that Black women might be particularly vulnerable to deficiencies in provision.Effective management of perinatal depression requires more robust implementation ofexisting guidelines, more effective strategies to address the full spectrum of need,improved training of professionals, and a more coordinated multi-agency approach.