Abstract
Introduction
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.
Methods
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.
Findings
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.
Conclusion
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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Biography
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.
Biography
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.
Biography
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.
Biography
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.
Article info
Publication history
Accepted:
March 16,
2011
Received in revised form:
March 11,
2011
Received:
July 21,
2010
Footnotes
Support for this research was provided by the Family League of Baltimore City, Inc., the Maryland Governor’s Office for Children, and the Johns Hopkins Institute for Clinical and Translational Research. The authors have no financial conflicts of interest to disclose. The first author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Identification
Copyright
© 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
