Understanding the help-seeking behaviours of women at risk of postnatal depression

Abstract

Background: Postnatal depression, which affects between 10 and 25% of women worldwide, is a major public health problem. However, studies have shown that patients with postnatal depression engage poorly with treatment. Objectives: This qualitative study aims to examine the help-seeking behaviours amongst women who were screened to be at risk of postnatal depression in a public maternity hospital. Methods: From April 2008 to January 2010, 214 women who returned to a public maternity hospital for their postnatal obstetric check-ups were screened to be at risk of postnatal depression, with scores of 13 and above on the Edinburgh Postnatal Depression Scale (EPDS). Of these, 48 women agreed to participate in an open-ended phone interview which explored facilitators and barriers to help-seeking. The interviews were audio-recorded, transcribed and analysed to identify recurrent themes. Results: Three overarching themes and corresponding sub-themes were identified: personal motivations for seeking treatment (wish to be a better mother, desire for emotional support, wish for diagnosis), external facilitators for seeking treatment (family support, referral by obstetrician, postnatal emotional health screening) and barriers to seeking treatment (practical concerns, stigma, lack of knowledge about postnatal depression). Conclusions: The barriers and facilitators reported by study participants were consistent with those in existing literature, though participants’ personal motivations for seeking treatment have not been widely reported. Potential interventions to encourage help-seeking in women at risk of postnatal depression should address barriers and facilitators of help-seeking, and women’s personal motivations for seeking treatment should be explored in greater detail.