Perinatal Mental Healthcare Needs Among Women at a Community Hospital.

OBJECTIVE: Mental health problems affect up to 20% of women during pregnancy and the postpartum period. This study aimed to describe the mental health services and resources accessed by women with perinatal mental health problems (PMH) and to identify their unmet mental health care needs and preferences for support, as well as the barriers to accessing this support. METHODS: Participants were 18 years of age or older and spoke English or French. Consent was obtained 24 hours after delivery (T0) to screen for symptoms of depression and anxiety at 2 weeks postpartum (T1) using the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder Scale (GAD-7). Women with a positive screen (EPDS ≥10 or GAD-7 ≥10) were sent informational resources and were followed-up by telephone at 4 months postpartum (T2) to determine their use of these and other resources, their unmet needs, and their preferences for other resources or services. RESULTS: Seventy-three out of 344 participants (21.2%) screened positive, of whom 57 (78%) completed the T2 interview. Of those interviewed, 28% had used the informational resources provided by the study. Although 25% had consulted a health professional for mental health care, 37% had unmet mental health care needs. Preferences for additional support included web-based resources (30%), telephone support (28%), and booklets (25%). Lack of time (38%) and lack of childcare (23%) were the main barriers to seeking help. CONCLUSIONS: Web- and telephone-based approaches have the potential to address the most common barriers to access support for women experiencing perinatal mental health problems.

Effect of the Postpartum Hospital Environment on the Attainment of Mothers' and Fathers' Goals.

OBJECTIVE: To describe mothers' and fathers' goals in the postpartum period and how the hospital environment enables or hinders the attainment of these goals. DESIGN: A qualitative descriptive design was used to explore participants' perceptions. SETTING: Mothers and fathers were recruited on the postpartum unit of an urban hospital. PARTICIPANTS: Ten mothers and eight fathers participated. METHODS: Semistructured interviews were conducted with mothers and fathers individually. Data analysis occurred concurrently with data collection and informed subsequent interviews. RESULTS: Mothers and fathers expressed similar goals: developing parenting competence and fulfilling personal needs. Their narratives indicated that the organizational environment with the mission to promote and provide baby-friendly and family-centered care and the human environment of responsive nursing were closely aligned with their goals. In contrast, the routines of the unit and the physical environment were not consistent with parents' goals or the mission of the organization. CONCLUSION: Nurses have important advocacy roles in ensuring that all dimensions of the postpartum environment support the ability of parents to attain their goals and align with the philosophy of care of the organization.