Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed-methods study of mental health care staff

  1. C. A. Wilson
  2. C. Dalton-Locke
  3. S. Johnson
  4. A. Simpson
  5. S. Oram
  6. L. M. Howard

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Abstract

The aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (‘perinatal’ women). Secondary analysis was undertaken of an online mixed-methods survey open to all mental health care staff in the UK involving 363 staff working with women in the perinatal period. Staff perceived the mental health of perinatal women to be particularly vulnerable to the impact of stressors associated with the pandemic such as social isolation (rated by 79.3% as relevant or extremely relevant; 288/363) and domestic violence and abuse (53.3%; 192/360). As a result of changes to mental health and other health and social care services, staff reported feeling less able to assess women, particularly their relationship with their baby (43.3%; 90/208), and to mobilise safeguarding procedures (29.4%; 62/211). While 42% of staff reported that some women engaged poorly with virtual appointments, they also found flexible remote consulting to be beneficial for some women and helped time management due to reductions in travel time. Delivery of perinatal care needs to be tailored to women’s needs; virtual appointments are perceived not to be appropriate for assessments but may be helpful for some women in subsequent interactions. Safeguarding and other risk assessment procedures must remain robust in spite of modifications made to service delivery during pandemics.

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  1. Version published to 10.1007/s00737-021-01108-5
  2. ScreenIT

    SciScore for 10.1101/2020.09.23.20199927: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The King’s College London Research Ethics Committee approved the study (MRA-19/20-18372).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableThe sample comprised those who reported working with pregnant or postnatal women in generic or perinatal specialist services (community teams or inpatient Mother and Baby Units: MBUs) and who completed at least one question from each of the three main sections of questions open to all respondents described above, as per the approach taken by a previous analysis of the full sample of respondents (Johnson et al. 2020).

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Quantitative data were analysed using Stata 15 (StataCorp 2007) and are presented as descriptive statistics.
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: This is the first study to document the experiences of mental health care staff supporting women in the perinatal period during the COVID-19 pandemic. The use of both qualitative and quantitative data facilitate triangulation of our findings (Tracy 2010). However, there are some limitations posed by the convenience nature of the sample. Despite efforts to recruit a broad ethnic demographic, the number of non-White respondents in this sample is relatively small. There is also limited geographical diversity, with most of the respondents being from England; there may be different experiences in the UK’s devolved nations, with differing levels of perinatal mental health service provision, which were not adequately captured. Most of the staff were working in community services, with only 18 respondents from the MBU. There were also no questions about the experiences of partners of perinatal women so these experiences were not captured. Furthermore, the sample included both staff working only in perinatal services and other staff working with perinatal women among other service users or in non-perinatal settings. Yet we believe the latter group is more representative of the structure of health services in many places outside the UK where there are no dedicated perinatal mental health services. Moreover, analyses in which only responses from staff working exclusively in perinatal services were analysed did not reveal substantial deviation from the larger s...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.09.23.20199927 on medRxiv