Multilevel Barriers to Perinatal Mental Healthcare among Minority Ethnic Women in the United Kingdom (UK): A Systematic Review

Abstract

Background: In the United Kingdom (UK), women belonging to the minority ethnic population report with a significantly higher postnatal mental condition and experiences a unique multilevel barrier along perinatal mental health care services.  This study aims to investigate the different factors constituting these barriers and inadequate perinatal care experienced among this population in the UK.

Methods: This study employs a secondary research approach following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, MEDLINE, and CIHNAL were searched using relevant keywords and studies included in the review are selected using specific predefined inclusion criteria. Quality appraisal of selected articles was done using the Critical Appraisal Skill Programme (CASP) and Mixed Methods Appraisal Tools (MMAT) for qualitative and quantitative articles, respectively. Each selected article was synthesised thematically to identify patterns relevant to the research question.

Results: The study revealed that barriers to obtaining desirable perinatal mental health services for women of minority ethnicities were found across four distinct levels. Factors identified within each level include insufficient knowledge and resources, negative perception, choice of treatment, fragmentation in service components, cultural insensitivity, factors attributed to social isolation including stigma, shame, guilt, loneliness and language issues were identified as some of the challenges resulting in the undesirable experience within the population.

Conclusion: There exist multilevel challenges faced by women belonging to the minority ethnic population in accessing perinatal mental health in the UK. It identified that the perinatal mental health of women in this population is unequally catered for, highlighting the need for robust multilevel strategies targeting individual, organizational, sociocultural and structural barriers.