Original article| Volume 21, ISSUE 4, P314-319, July 2011

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Perceptions of Mental Health Services among Low-Income, Perinatal African-American Women



      The objective of this qualitative study was to explore perceptions of mental health services as a barrier to service use among low-income, urban, perinatal African-American clients of home visiting programs.


      Inductive thematic analysis procedures were used to analyze data collected from focus groups conducted with clients (n = 38) and staff (n = 26) of two paraprofessional home visiting programs.


      Four complementary themes were identified: Perceptions of mental health care providers, concerns about confidentiality, beliefs about the effectiveness of psychotherapy, and perceptions of psychotropic medication. Overall, perceptions of mental health services were largely negative. Many women equated seeing a mental health care provider with being prescribed psychotropic medication, and providers were commonly described as uncaring and emotionally detached. In general, psychotherapy was perceived as ineffective, and many women expressed strong negative views about psychotropic medication.


      Perceptions of mental health services were clearly an impediment to service use in this population of low-income, perinatal African-American women. Findings from this study can inform efforts to overcome barriers to mental health service use and develop effective perinatal mental health interventions. Implications of this work include use of the home visitation setting as a context for delivering knowledge and shaping positive attitudes and behaviors with respect to mental health practices.
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      Julie A. Leis, PhD, is a postdoctoral fellow in the Department of Pediatrics at The Johns Hopkins University School of Medicine. Her research interests include perinatal mental health, prevention of maternal depression, and integrating mental health care into alternative settings.


      Tamar Mendelson, PhD, is an assistant professor in the Department of Mental Health at The Johns Hopkins Bloomberg School of Public Health. Her research interests include the development and evaluation of interventions to promote mental health among underserved populations.


      Deborah F. Perry, PhD, is an associate professor at the Georgetown University Center for Child and Human Development. Dr. Perry’s research focuses on community-based participatory approaches to designing and testing preventive mental health interventions for young children and their caregivers.


      S. Darius Tandon, PhD, is an Assistant Professor in the Department of Pediatrics at The Johns Hopkins University School of Medicine. His research focuses on the prevention of mental disorders among vulnerable populations, including preventing postpartum depression among women in home visitation programs.