title: 'It's leaflet, leaflet, leaflet then, "see you later"': black Caribbean women's perceptions of perinatal mental health care.
abstract: BACKGROUND
  Despite high levels of psychosocial risks, black women of Caribbean origin rarely consult health professionals regarding symptoms of perinatal depression. Reasons for this are unclear as there has been little perinatal mental health research among this ethnic group.
  
  
  OBJECTIVE
  To examine stakeholder perspectives on what might account for low levels of consultation for perinatal depression among a group of women who are, theoretically, vulnerable.
  
  
  METHODS
  A qualitative study using focus group interviews.
  
  
  METHODS
  Community settings in the northwest of England.
  
  
  METHODS
  A purposive sample of black Caribbean women (n = 42) was split into focus groups and interviewed. This sample was drawn from a larger study. Interviews were digitally recorded and transcribed verbatim. Framework analysis was used to generate themes.
  
  
  RESULTS
  Perceptions of practitioners' lack of compassion in delivering physical care and women's inability to develop confiding relationships with professionals during pregnancy and childbirth were significant barriers to consulting for depressive symptoms in particular, and health needs more generally. Advocating a 'stepped-care' approach, black Caribbean women suggested that new care pathways are required to address the full spectrum of perinatal mental health need. Apparently eschewing mono-ethnic, 'culturally sensitive' models, women suggested there was much to be gained from receiving care and support in mixed ethnic groups.
  
  
  CONCLUSIONS
  Black Caribbean women's suggestions for more collaborative, community-based models of care are in line with policy, practice, and the views of members of other ethnic groups. Adopting such approaches might provide more sustainable mechanisms for improving access and engagement both among so-called hard-to-reach groups and more generally, thereby potentially improving maternal and child outcomes.
authors: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. dawn.edge@manchester.ac.uk
authors: Dawn
authors: D
authors: Edge
mesh_terms: D000293:Adolescent; D000328:Adult; D019052:Depression, Postpartum / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D004739:England / Q000453:epidemiology; D005260:Female; D017144:Focus Groups; D058006:General Practice / Q000592:standards; D006801:Humans; D010174:Pamphlets; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D017060:Patient Satisfaction; D010465:Perception; D018743:Perinatal Care / Q000592:standards*; D011247:Pregnancy; D036301:Qualitative Research; D011787:Quality of Health Care; D014900:West Indies / Q000208:ethnology; D055815:Young Adult