Understanding the Complexities of Peripartum Mood and Anxiety Disorders: A Qualitative Assessment of Current Issues in Management and Treatment

Objectives: Perinatal Mood and Anxiety Disorders (PMADs) are an important public health issue that can have detrimental consequences to both the woman and the child. Despite our extensive understanding about the consequences and the availability of treatments, only 3% individuals with PMADs are treated to remission. Our aim was to understand the community’s needs, barriers to accessing care for PMADs, and obtain feedback on current services. Methods: In this study, we carried out qualitative interviews with 32 relevant individuals from varied backgrounds to understand the complexities related to PMADs and barriers to help-seeking. These narratives were transcribed, and an inductive thematic analysis approach was used to identify codes which were used in an iterative manner until data saturation was reached. Results: Three broad themes were identified related to the key questions including prevalence, barriers to care and finally, service needs and home visiting programs. All participants acknowledged the high prevalence of PMADs, particularly during and after the COVID-19 pandemic. They identified multiple barriers related to individual attitudes, knowledge, and stigma; health systems knowledge, attitude and access; and social determinants including poverty, race, geography, childcare and insurance. They also identified societal and cultural attitudes and the role of social support systems in help-seeking. All participants acknowledged the importance of home-visiting programs in addressing the needs of peripartum individuals. Conclusion: Our findings provide an in-depth insight into the complex underpinnings of PMADs, particularly barriers to accessing care. This information, along with the positive feedback on home-visiting programs, can contribute to the development of innovative programs.