Syrian refugee women's experiences of barriers to mental health services for postpartum depression

Abstract

Objective: To describe Syrian refugee women's experiences of the barriers to access mental health services for postpartum depression (PPD). Design: A descriptive qualitative study was conducted. Methods: Fifteen purposefully selected Syrian refugee women who scored >= 10 on the Edinburgh Postnatal Depression Scale participated in the semi-structured telephone interviews. Transcripts were coded verbatim and analysed thematically according to the dimensions of Levesque's model of patient-centred access to healthcare. Data were collected between August 2022 and February 2023. Results: Five themes with 14 subthemes were identified: (1) approachability covered lack of knowledge and misconceptions related to PPD and its treatment, lack of awareness of available psychosocial services and perceived need of mental health treatment; (2) acceptability comprised being a refugee, stigma of mental illness, cultural preferences of healthcare provider and language barrier; (3) availability and accommodation encompassed transportation barrier and location of the centre, no support for childcare and lack of time; (4) affordability included financial difficulties and health insurance coverage; (5) appropriateness comprised no screening for PPD and intermittent services with limited focus on mental health. Conclusions: The findings of this study reveal that Syrian refugee women experienced multi-faceted complex barriers to access mental health services for PPD. It is important for health professionals, including nurses, and policymakers to address the cultural mental health needs of this population and establish strategies to protect their legal and health rights. Impact: Our study has important practice and policy implications for establishing strategies designed specifically for refugee mothers to mitigate their perceived barriers to PPD treatment and ultimately improve their mental health. Reporting Method: The Consolidated Criteria for Reporting Qualitative Research was used. Patient or Public Contribution: No patient or public contribution. Participants were Syrian refugee women with PPD symptoms and contributed only to the interviews and member checking.