"And in some cases, we're the best option:" A qualitative study of community-based doula support for black perinatal mental health.

Abstract

We explored community-based doulas' perspectives on the acceptability of using formal screening tools to address low rates of mental health screening, diagnosis, and treatment for perinatal anxiety and depression among Black women. Using thematic analysis, we analyzed interview data from 30 community-based doulas who support Black families during pregnancy, birth, and the postpartum period. Approximately 57% of community-based doulas supported mental health screening; 23% opposed, and 20% were unsure of whether or not to screen. Four themes emerged from participants' responses, including (1) rethinking screening approaches and procedures; (2) cultural and contextual screening; (3) community-based doula roles; and (4) client mistrust of mental health questionnaires. Additionally, there were four themes that highlighted community-based doulas' perspectives of how they might advocate for this population, including (1) bridge to mental health; (2) identification and normalization of symptoms; (3) systemic issues; and (4) mental health specialization. Partnering with trusted community-based doulas might improve perinatal mental health screening and prevention efforts for Black women experiencing perinatal anxiety and depression.