Toward recovery-oriented perinatal healthcare: A participatory qualitative exploration of persons with lived experience and health providers' views and experiences

Perinatal mental health disorders (PMHD) remain often undetected, undiagnosed, and untreated with variable access to perinatal mental health care (PMHC). To guide the design of optimal PMHC (i.e., coproduced with persons with lived experience [PLEs]), this qualitative participatory study explored th...

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Bibliographic Details
Published in:	European psychiatry Vol. 66; no. 1; p. e86
Main Authors:	Dubreucq, Marine, Thiollier, Mathilde, Tebeka, Sarah, Fourneret, Pierre, Leboyer, Marion, Viaux-Savelon, Sylvie, Massoubre, Catherine, Dupont, Corinne, Dubreucq, Julien
Format:	Journal Article
Language:	English
Published:	England Cambridge University Press 20-10-2023
Subjects:	Autism Bipolar disorder coproduction with persons with lived experience Female Focus groups Health services Health Services Accessibility healthcare improvement Humans Interviews Mental depression Mental disorders Mental Disorders - diagnosis Mental Disorders - therapy Mental health care Mothers Participatory research perinatal mental health disorders personal recovery Pregnancy Psychiatrists Qualitative Research Research design Researchers Schizophrenia Social Stigma stigma Womens health United Kingdom > UK France perinatal mental health disorders coproduction with persons with lived experience stigma personal recovery healthcare improvement
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Summary:	Perinatal mental health disorders (PMHD) remain often undetected, undiagnosed, and untreated with variable access to perinatal mental health care (PMHC). To guide the design of optimal PMHC (i.e., coproduced with persons with lived experience [PLEs]), this qualitative participatory study explored the experiences, views, and expectations of PLEs, obstetric providers (OP), childcare health providers (CHPs), and mental health providers (MHPs) on PMHC and the care of perinatal depression. We conducted nine focus groups and 24 individual interviews between December 2020 and May 2022 for a total number of 84 participants (24 PLEs; 30 OPs; 11 CHPs; and 19 MHPs). The PLEs group included women with serious mental illness (SMI) or autistic women who had contact with perinatal health services. We recruited PLEs through social media and a center for psychiatric rehabilitation, and health providers (HPs) through perinatal health networks. We used the inductive six-step process by Braun and Clarke for the thematic analysis. We found some degree of difference in the identified priorities between PLEs (e.g., personal recovery, person-centered care) and HPs (e.g., common culture, communication between providers, and risk management). Personal recovery in PMHD corresponded to the CHIME framework, that is, connectedness, hope, identity, meaning, and empowerment. Recovery-supporting relations and peer support contributed to personal recovery. Other factors included changes in the socio-cultural conception of the peripartum, challenging stigma (e.g., integrating PMH into standard perinatal healthcare), and service integration. This analysis generated novel insights into how to improve PMHC for all users including those with SMI or autism.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0924-9338 1778-3585
DOI:	10.1192/j.eurpsy.2023.2464