Experiences of Improving Access to Psychological Therapy Services for Perinatal Mental Health Difficulties: a Qualitative Study of Women's and Therapists' Views

Behav Cogn Psychother. 2018 Jul;46(4):421-436. doi: 10.1017/S1352465817000650. Epub 2017 Oct 30.

Abstract

Background: Perinatal mental health difficulties are highly prevalent. In England, the Improving Access to Psychological Therapy (IAPT) programme provides evidence-based psychological treatment, predominantly in the form of brief manualized cognitive behavioural therapy (CBT), to people with mild to moderate depression or anxiety. Yet little is known about the experiences of women referred to IAPT with perinatal mental health difficulties.

Aims: The aim of this qualitative study was to investigate how women view IAPT support for perinatal mental health. We also gained the perspective of IAPT therapists.

Method: Semi-structured interviews were conducted with twelve women who had been referred to and/or received therapy from IAPT during the perinatal period. Additionally, fourteen IAPT therapists participated in two focus groups. Thematic analysis was used.

Results: Key themes centred on barriers to access and the need to tailor support to (expectant) mothers. Women and therapists suggested that experiences could be improved by supporting healthcare professionals to provide women with more help with referrals, better tailoring support to the perinatal context, improving perinatal-specific training, supervision and resources, and offering a more individualized treatment environment.

Conclusions: Overall, women reported positive experiences of support offered by IAPT for perinatal mental health difficulties. However, services should seek to facilitate access to support and to enable therapists to better tailor treatment.

Keywords: CBT; IAPT; perinatal mental health; qualitative methods.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / psychology
  • Anxiety / therapy
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy
  • Attitude of Health Personnel*
  • Cognitive Behavioral Therapy
  • Depression / psychology
  • Depression / therapy
  • England
  • Female
  • Health Services Accessibility*
  • Humans
  • Interviews as Topic
  • Mental Health Services / supply & distribution*
  • Mental Health*
  • Middle Aged
  • Mothers / psychology*
  • Mothers / statistics & numerical data
  • Pregnancy
  • Psychology*
  • Qualitative Research
  • Racial Groups / statistics & numerical data
  • Referral and Consultation
  • Women's Health / statistics & numerical data*
  • Young Adult