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42 items found for ""

  • Language Barriers | MATRIx

    INTERPERSONAL Language barriers​ A barrier to communication between people who do not speak the same language. Language barriers. Resources. Language barriers Health professionals and women not being able to understand each other, and therefore have difficulties with communicating due to language barriers is a barrier to care "When the midwife visits, I can only speak the sentences about requesting a translator … They said that this kind of service is limited … that is what is difficult being Chinese—language barrier."​ ​ Evidence level: ​High ​ ​Parts of the care pathway affected: Deciding to consult, First Contact with Health Professional, Assessment, Decision to disclose, Provision of optimal treatment, Women’s experience of treatment​. ​ Key literature: ​ Sambrook Smith M, et al. 2019 Resources Resources that can be used to reduce difficulties with language barriers within services​ ​ ACACIA Family support provide pre and postnatal depression support services. They have translated patient information into multiple languages (Arabic, Bengali, Chinese, French, Hindu, Polish, Punjabi, Romanian, Samoan & Urdu). “How are you feeling?” screening tools by Abi Sobowale (Sheffield South West NHS Trust)​. Guidance from Public Health England about language interpreting and translation: Recommendations We recommend service managers ensure recruitment of a diverse workforce​. ​ We recommend service managers recruit translators or form partnerships with other agencies that can provide additional support (e.g. translation services, interpreters) to translate infographics/leaflets into local languages and to act as an interpreter at appointments if women feel comfortable. ​ We recommend service managers consider investment in live translation tools or telephone interpreting such as Language Line.​ Back to Interpersonal

  • Practical Difficulties | MATRIx

    INDIVIDUAL Practical Difficulties Certain practical difficulties act as barriers to women seeking help and accessing perinatal mental health care, as well as the successful implementation and delivery of perinatal mental health care. These include:​ Lack of childcare​ Travel to services​ Timing and flexibility of services Lack of childcare Lack of childcare may act as a barrier to perinatal mental health care​​. ​ "They cannot take their child with them to their session. . .(and) a lot of times they cannot afford day care​​". ​ Evidence level: Low​ ​ ​Parts of the care pathway affected: Access to treatment​. ​ Key literature: ​ Boyd RC, et al. 2011 Location and travel costs The location of services, and the costs of travelling to services may act as a barrier to perinatal mental health care​. ​ "Yes, there was the issue of travelling. I cannot drive and my husband was admitted to the hospital​".​ ​ ​Evidence level: Low​ ​ ​Parts of the care pathway affected: Access to treatment​. ​ ​Key literature: ​ Masood Y, et al. 2015 Inflexible timing Inflexible timing of appointments may act as a barrier to perinatal mental health care​. ​ "Mothers …expressed concerns about the logistics of attending a group meeting due to already overburdened days…Some depressed mothers refused to seek treatment due to perceived insufficient time (42) and the inconvenience of attending appointments (21)​​".​ ​ ​Evidence level: Low​ ​ ​Parts of the care pathway affected: Access to treatment​. ​ ​Key literature: ​ Dennis CL & Chung-Lee L. 2006 Recommendations More research is needed into practical barriers to accessing perinatal mental health care using rigorous methodology, before recommendations for policy and practice can be made. Back to Individual

  • Social and Family Life | MATRIx

    INDIVIDUAL Social and Family Life​ A woman’s social and family life can impact help seeking, access to care, and delivery and implementation of care. ​ Social isolation​ Family and friends​ Additional personal difficulties​ Social isolation​ Social isolation can act as a barrier to perinatal mental health care, whereas social support can be a facilitator​​. ​ "Those without social relationships felt an additional burden when dealing with PPD​​ [postpartum depression]" ​ Evidence level: Moderate​ ​ ​Parts of the care pathway affected: Decision to consult, Women’s experience of treatment​. ​ Key literature: ​ Hansotte E, et al. 2017 Family and friends​ Supportive family and friends can be a facilitator to perinatal mental health care, whereas having little support from family and friends is a barrier​. ​ "It was sort of my partner saying to me: “Right, if you don’t go, I’m basically making nyou an appointment … You can’t just keep feeling like this".​ ​ ​Evidence level: Moderate​ ​ ​Parts of the care pathway affected: Decision to consult, Assessment, Decision to disclose, Access to treatment, Women’s experience of treatment​. ​ ​Key literature: ​ Button S, et al. 2017 Additional personal difficulties​ Personal difficulties outside of perinatal mental illness such as unemployment can act as barriers to perinatal mental health care​. ​ "I have this one client. . .(who) has so many issues going on, abusive relationship which she got out of and then custody battle with the children that are going to be a year in June and she is also pregnant. . .She had so much going on that she rejected the (mental health) referral​​". ​ ​Evidence level: Moderate​ ​ ​Parts of the care pathway affected: Decision to disclose, Access to treatment​. ​ ​Key literature: ​ Boyd RC, et al. 2011 Recommendations Social isolation can be a barrier to care for some women. We therefore recommend service managers considering offering peer support to women where appropriate. Not being financially stable, and other personal difficulties can be a barrier to care. We therefore recommend the government provide a fair welfare and economic system that ensures that no one is living in poverty or in financial hardship. Back to Individual

  • Trusing Relationship and Raport | MATRIx

    INTERPERSONAL Trusting relationship and rapport​ The development of a trusting relationship and rapport between health professionals and women​. Trusting relationship and rapport​. Difficulties developing a trusting relationship. Trusting relationship and rapport​ The development of a trusting relationship is a facilitator to perinatal mental health care. "It’s like family, almost. You know what I mean? It’ s somewhere where you already feel comfortable.​."​ ​ Evidence level: ​ High ​ ​Parts of the care pathway affected: Deciding to consult, Assessment, Decision to disclose, Access to treatment, Provision of optimal treatment, Women’s experience of treatment​. ​ Key literature: ​ Young CA, et al. 2019 Difficulties developing a trusting relationship Difficulties developing a trusting relationship and rapport between health professionals and women is a barrier to perinatal mental health care​.​ ​ "I didn’t trust them I suppose so I didn’t tell the health visitors how I was feeling​".​ ​ ​Evidence level: High​ ​ ​Parts of the care pathway affected: Deciding to consult, Assessment, Decision to disclose, Access to treatment, Provision of optimal treatment, Women’s experience of treatment​ ​ ​Key literature: ​ Shakespeare J, et al. 2003 Recommendations To ensure there are opportunities for health professionals and women to form trusting relationships, we recommend continuity of carer across the care pathway. A good example of this is The Tower Team based in the Tower Hamlets, London is a high-risk caseload midwifery team that works closely with the perinatal mental health team and the consultant obstetrician for mental health at St. Thomas’ hospital. The Tower Team offers continuity of care for women with severe mental illness from their maternity booking appointment, throughout pregnancy, intrapartum and for up to 28 days postpartum. Back to Interpersonal

  • Commissioners | MATRIx

    Commissioners Care pathways Appropriate and timely services Funding Back to Conceptual Framework

  • Policy Makers | MATRIx

    Policy Makers Immigration status​ Economic status and healthcare costs​ Back to Conceptual Framework

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