Barriers and Supports for the Identification and Treatment of Perinatal Mood and Anxiety Disorders: A Qualitative Analysis of Patient Experience Data

Perinatal mental health is a rising public health concern in the United States, with mental health conditions, including suicide and overdose, the leading cause of pregnancy-related deaths. Despite guidelines recommending that maternal healthcare providers screen all patients for perinatal mood and anxiety disorders (PMADs) and refer them to appropriate care, screening rates are low, and many perinatal people continue to experience symptoms of PMADs well after 1 year postpartum. Utilizing the conceptual framework of the treatment continuum- clinical recognition of treatment, adequate treatment, and engagement in effective treatment- this research highlights factors occurring within and outside the medical system that impact perinatal people's recovery from PMADs. We conducted 39 semi-structured interviews with participants in a rural state who had experienced pregnancy within the past five years. The main themes of the results were: 1) Recognition of PMADs; 2) Initiation of Treatment; and 3) Adequacy of Treatment. Key barriers to PMAD identification and recovery were low capacity and support in the postpartum period, stigma, fear of CPS, inadequate screening, hesitancy to take medication, lack of follow-up, and limited access to mental health. Participants highlighted the crucial role of informal support from partners, families, friends, and community members in recognizing symptoms and encouraging treatment. The findings underscore the need for improved education and training for both providers and patients about PMADs, enhanced screening processes, and better access to mental healthcare.