Barriers to accessing treatment in perinatal depression: a qualitative and quantitative study

This study aims to identify culture and region-specific barriers to seeking treatment in women at risk for depression during the perinatal period, which may have been previously overlooked. The study was conducted in two stages using both qualitative ve quantitative methods. Participants included women who were screened for depression risk using the Edinburgh Postnatal Depression Scale (EPDS) at the gynecology ve obstetrics clinic of Sakarya Training ve Research Hospital between January and December 2022. Women identified as at risk for depression and referred to the perinatal psychiatry outpatient clinic but who did not seek treatment were included. In the qualitative stage, 20 participants completed a sociodemographic data form ve the EPDS, followed by a qualitative interview. The qualitative component was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). In the quantitative stage, 66 participants were administered a sociodemographic data form, the EPDS and a quantitative questionnaire developed based on the qualitative findings. The qualitative analysis revealed five themes: individual factors, environmental factors, sociocultural factors, stigma-related factors, and clinical factors. In the quantitative analysis, the top three barriers identified were: “the societal expectation that household chores such as cleaning, ironing, cooking, ve childcare are women’s responsibilities”, “the burden of these household tasks,” and “the prioritization of daily life responsibilities over mental health concerns.” A positive correlation was found between the EPDS scores and the following questionnaire items: “lack of a safe place to leave the child”, “mental health issues perceived as unimportant by close contacts”, “the burden of household tasks”, “the prioritization of daily life responsibilities over mental health concerns”, “the societal expectation of women’s responsibility for household chores” and “lack of support or indifference from a partner during pregnancy and the postpartum period.“. In the qualitative phase, five themes emerged: individual factors, environmental factors, sociocultural factors, stigma-related factors and health provider-related factors. In the quantitative phase, the three highest-scoring questions were primarily related to sociocultural factors. Not applicable.