title: Falling through the net - black and minority ethnic women and perinatal mental healthcare: health professionals' views.
abstract: OBJECTIVE
  The objective of this study was to investigate health professionals' views about perinatal mental healthcare for Black and minority ethnic women.
  
  
  METHODS
  Qualitative data were collected from a range of healthcare professionals (n=42) via individual interviews and focus groups. Participants were recruited from antenatal community clinics, a large teaching hospital, general practice and a specialist voluntary sector agency in the north of England, UK.
  
  
  RESULTS
  Participants reported inadequacies in training and lack of confidence both for identifying the specific needs of Black women and for managing perinatal depression more generally, particularly in women with mild/moderate and 'subthreshold' depression. Inadequate perinatal depression management was associated with failure to screen routinely, confusion about professional roles and boundaries, and poorly defined care pathways, which increased women's likelihood of 'falling through the net,' thus failing to receive appropriate care and treatment.
  
  
  CONCLUSIONS
  Suboptimal detection and treatment of perinatal depression among 'high-risk' women highlight gaps between UK policy and practice. This applies to women from all ethnic groups. However, evidence suggests that Black women might be particularly vulnerable to deficiencies in provision. Effective management of perinatal depression requires a more robust implementation of existing guidelines, more effective strategies to address the full spectrum of need, improved professional training and a more coordinated multiagency approach.
authors.affiliation: School of Nursing, Midwifery and Social Work, University Place, The University of Manchester, Manchester M13 9PL, UK. dawn.edge@manchester.ac.uk
authors.forename: Dawn
authors.initials: D
authors.lastname: Edge
mesh_terms: D001291:Attitude of Health Personnel; D044383:Black People / Q000523:psychology*; D003863:Depression; D004739:England; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008913:Minority Groups / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care / Q000523:psychology*; D013222:State Medicine; D014900:West Indies / Q000208:ethnology