Improving education in perinatal mental health: a participatory qualitative analysis

Objective: A recent systematic review found that education programs in perinatal mental health (PMH) had limited effects on detection, referral, and support of parents with perinatal mental health problems (PMHPs). This qualitative study sought to explore the experiences, views and priorities of persons with lived experience (PWLEs), obstetric providers (OPs), childcare health providers (CHPs) and mental health providers (MHPs) on education in PMH. Design/Setting: We used a participatory research design, i.e. co-production by academic researchers and researchers with lived experience as equal partners. We recruited PWLEs through Maman Blues' association and a centre for psychiatric rehabilitation, and providers through perinatal health networks. Sample/Methods: We conducted nine focus groups and 24 individual interviews between December 2020 and May 2022 for a total number of 84 participants (24 PWLEs; 30 OPs; 11 CHPs and 19 MHPs). We used Braun & Clarke's inductive six-step process in the thematic analysis. Results: We found some degree of difference in the priorities for education in PMH identified by PWLEs (e.g. person-centred collaborative perinatal healthcare) and providers (e.g. knowledge about PMHPs). Providers considered PMH assessment as part of their role but reported feeling ill-prepared to do so and negative attitudes about their role in perinatal mental health care for parents with suicidal ideations or serious mental illness. Organisational factors comprised PMH integration into standard perinatal healthcare and common culture between non-MHPs and MHPs. Conclusions: Education programs in PMH should be co-designed with PWLEs and focus on providing collaborative person-centred care for all parents.