Psychotic-like experiences, intrusive thoughts, and access to mental healthcare in the perinatal period

Hunt, Tammy (2024) Psychotic-like experiences, intrusive thoughts, and access to mental healthcare in the perinatal period. Doctoral thesis, University of East Anglia.

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Abstract

Background: Perinatal mental health (PMH) is a growing area of research and clinical practice. Strategies to improve PMH access needs to be tailored to the population and environment. Much of the PMH research has focused on mothers experiencing clinical mental health problems, but less is known about distressing symptoms of PMH problems in community samples. This thesis explores barriers to accessing PMH support in sub-Saharan Africa (SSA), factors associated with distressing intrusive thoughts (ITs) and psychotic-like experiences (PLEs), and the prevalence of these experiences in postnatal parents.

Method: A systematic review of barriers to accessing PMH support in SSA was conducted. A cross-sectional quantitative study was carried out exploring factors associated with distressing PLEs and ITs in postnatal parents using an online survey.

Results: Thirteen studies met inclusion criteria for the systematic review. Main barriers to accessing PMH included low mental health literacy, significant stigma, contradictive support, limited resources, screening, formal support, training, and not involving loved ones. Factors unique to SSA included the lack of PMH policy, pluralism of traditional and biomedical care, stigma faced by adolescent mothers, and the need to integrate PMH into PHC.
The empirical paper found that 88.8% of parents experienced distressing PLEs and 90.8% experienced distressing ITs. Results showed that 35% of parents scored above the cut-off for potential risk of psychosis. Fewer parents were cohabiting, more were accessing mental health services, and mental health symptoms were more prevalent and severe in the potential risk group. Depression and distressing ITs were associated with increased PLE distress, while cohabitation reduced the likelihood of distress. A history of mental health difficulties, the number of ITs reported, stress, and anxiety were associated with increased IT distress.

Conclusion: There are barriers to accessing PMH support that are unique to SSA. These barriers should be considered when implementing PMH services in the region. PLEs and ITs are common. The rates of postnatal parents experiencing distressing PLEs and ITs and scoring above clinical cut-offs is higher than those accessing mental health services, indicating that further screening is needed to identify and support those at risk of developing postnatal mental health difficulties.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Nicola Veasy
Date Deposited:	19 Nov 2024 09:11
Last Modified:	19 Nov 2024 09:11
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97713
DOI:

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