'Whose pain is real pain and whose pain is not': an interpretative phenomenological analysis of the role of social support in help-seeking for perinatal mental illnesses in women from minoritised ethnicities.

Abstract

Rationale and objectives: Perinatal mental illnesses (PMIs), such as depression and anxiety, affect 25% of mothers in England and occur during pregnancy or within the first year postpartum. PMIs have serious consequences for mothers, children, and families, additionally impacting minoritised ethnic women who experience higher mental health risks and diminished quality of life, stemming from systemic inequalities, socio-economic disadvantages, and limited access to quality care. Social support influences women's help-seeking intentions and behaviours for PMIs, yet its role remains unclear. The present study aimed to investigate minoritised ethnic women's experiences of PMIs to understand the role of social support in help-seeking intentions or behaviour for formal or informal support.

Design: Semi-structured interviews were conducted with minoritised ethnic women (n = 6) in England. The interviews explored their experiences of PMIs, mental health, and views on social support during the perinatal period. The data was analysed using Interpretative Phenomenological Analysis.

Results: Minoritised ethnic women held varied perspectives on what constituted social support, ranging from immediate social circles to broader professional networks. Social support was not the sole determinant of help-seeking behaviours; self-perceptions, cultural background, and prior experiences with maternity care were also crucial. Additionally, a need for non-intrusive, empathetic, and culturally sensitive perinatal mental health support for minoritised ethnic women was expressed. The women emphasised the importance of creating safe spaces for open discussions, expressing a desire for peer support to foster a sense of belonging amongst minoritised ethnic women.

Conclusion: The role of social support in help-seeking for minoritised ethnic women is complex; functioning as both a facilitator and a barrier to help-seeking, contingent upon individual circumstances and subjective perceptions. The dissatisfaction expressed by women around the current perinatal care highlights the need for services in England to prioritise cultural humility and empathetic support to enhance outcomes for minoritised ethnic women.