Women's experience of postnatal depression - beliefs and attitudes as barriers to care

Objective Despite the increasing use of screening instruments to identify women with postnatal depression (PND), many do not access services and supports. It is unclear how women's experiences of PND influence their beliefs and attitudes and their choice to seek help. We will also explore ways family, friends and health professionals can facilitate help seeking behaviours. Design A qualitative study which explored: 'experiences after having a baby', 'recognition of symptoms', 'seeking help', 'treatment experiences and options' and 'ideal treatment'. Setting Participants were recruited from either hospital based outpatient PND treatment programs or community based mutual support programs. Subjects Forty women experiencing PND and either receiving treatment or attending support groups. Main Outcome Measure To gain an insight into the ways women experience PND and perceive their distress, and how this influences their beliefs and attitudes towards acknowledging their distress and seeking treatment. Results Findings suggest the lived experience of PND and associated attitudes and beliefs result in significant barriers to accessing help. Eight theme clusters were identified: expectations of motherhood; not coping and fear of failure; stigma and denial; poor mental health awareness and access; interpersonal support; baby management; help-seeking and treatment experiences and relationship with health professionals. Conclusion Implications for improved identification and management include helping health professionals to be aware of the personal and societal barriers preventing mothers from acknowledging their distress. Media campaigns may also be helpful in challenging community views of PND, as well as highlighting the range of treatment options available to mitigate concerns over medical/pharmacological approaches.