title: Addressing perinatal depression in a group of underserved urban women: a focus group study.
abstract: BACKGROUND
  Perinatal mental health problems are common complications of pregnancy that can go undetected and untreated. Research indicated that mental health complications are more prevalent in women from disadvantaged communities, yet women from these communities often experience barriers to accessing treatments and interventions. Untreated depression during pregnancy can lead to poor self-care, increased substance abuse, poor obstetrical outcomes, developmental delay in children, and increased risk of postpartum depression. In this study we investigated the perceived perinatal mental health needs of our participants and they wanted to address their perceived needs.
  
  
  METHODS
  In this qualitative study, we invited women who resided in an underserved, urban community who were pregnant or who delivered within the past year to participate in focus groups.
  
  
  RESULTS
  Thirty-seven women participated in seven focus groups. Thirteen themes emerged which were described in relation to mental health needs, help currently accessed and the type of support wanted. The themes included the various mental health needs including dealing with changing moods, depression, feelings of isolation, worrying and a sense of being burdened. Women described using a limited range of supports and help. Participants expressed a preference for mental health support that was empowerment focused in its orientation, including peer support. Women also described the compounding effect that social and economic stresses had on their mental health.
  
  
  CONCLUSIONS
  Participants wanted access to a greater range of supports for mental health than were currently available to them, including peer support, and wanted assistance in addressing social and economic needs. These findings offer a challenge to further broaden the types of services offered to women, and demonstrate that those services need to be responsive to the challenging contexts of women's lives. Integrating women's views and experiences into the development of services may help to overcome barriers to care.
authors.affiliation: Deborah E Powell Center for Women's Health, Departments of Psychiatry and Family Medicine and Community Health, Medical School, University of Minnesota Medical School, MMC 293 Mayo, 420 Delaware Street SE, Minneapolis, MN 55454, USA. raymo002@umn.edu.
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Raymond
authors.forename: Rebekah J
authors.initials: RJ
authors.lastname: Pratt
authors.forename: Amy
authors.initials: A
authors.lastname: Godecker
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Harrison
authors.forename: Helen
authors.initials: H
authors.lastname: Kim
authors.forename: Jesse
authors.initials: J
authors.lastname: Kuendig
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D008603:Mental Health; D020380:Needs Assessment; D011247:Pregnancy; D036301:Qualitative Research; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult