Evidence map›Paper›PMID 30679296›Full record

SynthesisBMJ open2019

Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK.

Megan Sambrook Smith, Vanessa Lawrence, Euan Sadler, Abigail Easter

2 registry-linked trialsAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 141 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
141citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04792671 unknown statusnot on this mapstarted 2021, after this paper: background citation

Prevalence and Risk Factors of Women Mental Health Disorders in Assiut Governorate

TypeobservationalSponsorAssiut UniversityRan2021 to 2023Enrolled200ConditionsPsychiatric Problem, Wolman DiseaseArmsSociodemographic variables, Family affluence scale (FAS), Edinburgh postnatal depression scale (EPDS), Symptom Checklist 90 "SCL 90":
NCT05046405 nanot yet recruitingnot on this mapstarted 2022, after this paper: background citation

Home-based Transcranial Direct Current Stimulation in Postpartum Depression: the Feasibility Study and Pilot Study

TypeinterventionalSponsorAna Ganho ÁvilaRan2022 to 2026Enrolled50ConditionsPostnatal DepressionArmsTranscranial Direct Current Stimulation
3 · Its place in the literature

Who cites it

141 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  14. Trial
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  16. Sleeping for Two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
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81 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Megan Sambrook SmithGlobal Mental Health, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
Vanessa LawrenceHealth Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Euan SadlerCentre for Implementation Science, Health Service & Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
Abigail EasterCentre for Implementation Science, Health Service & Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.ORCID 0000-0002-4462-6537

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveLack of access to mental health services during the perinatal period is a significant public health concern in the UK. Barriers to accessing services may occur at multiple points in the care pathway. However, no previous reviews have investigated multilevel system barriers or how they might interact to prevent women from accessing services. This review examines women, their family members' and healthcare providers' perspectives of barriers to accessing mental health services for women with perinatal mental illness in the UK.

designA systematic review and meta-synthesis of qualitative studies. DATA SOURCES: Qualitative studies, published between January 2007 and September 2018, were identified in MEDLINE, PsycINFO, EMBASE and CINAHL electronic databases, handsearching of reference lists and citation tracking of included studies. Papers eligible for inclusion were conducted in the UK, used qualitative methods and were focused on women, family or healthcare providers working with/or at risk of perinatal mental health conditions. Quality assessment was conducted using the Critical Appraisal Skills Programme for qualitative studies.

resultsOf 9882 papers identified, 35 studies met the inclusion criteria. Reporting of emergent themes was informed by an existing multilevel conceptual model. Barriers to accessing mental health services for women with perinatal mental illness were identified at four levels: Individual (eg, stigma, poor awareness), organisational (eg, resource inadequacies, service fragmentation), sociocultural (eg, language/cultural barriers) and structural (eg, unclear policy) levels.

conclusionsComplex, interlinking, multilevel barriers to accessing mental health services for women with perinatal mental illness exist. To improve access to mental healthcare for women with perinatal mental illness multilevel strategies are recommended which address individual, organisational, sociocultural and structural-level barriers at different stages of the care pathway. PROSPERO REGISTRATION NUMBER: CRD42017060389.

Indexed as

Health Services AccessibilityCommunication BarriersFemaleHelp-Seeking BehaviorHumansMaternal Health ServicesMental DisordersMental Health ServicesParturitionPregnancyPregnancy ComplicationsPregnant PeopleQualitative ResearchSocial StigmaUnited Kingdombarriersmental healthpregnancyqualitative researchsystematic review

Identifiers

PMID30679296
PMCPMC6347898

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.