Barriers to access to treatment in perinatal depression - a qualitative and quantitative review

AIM: This study aimed to identify culture- and region-specific barriers that prevent women at risk for perinatal depression from seeking treatment. MATERIALS AND METHODS: The study was conducted in two stages using qualitative and quantitative methods. Participants were women at risk for depression, identified via the Edinburgh Postpartum Depression Scale (EPDS) at the obstetrics clinic in 2022. Despite being referred to the perinatal psychiatry clinic, these women did not seek treatment. In the qualitative stage, 20 participants completed a sociodemographic data form and the EPDS, followed a qualitative interviews. In the quantitative stage, 66 participants were administered the sociodemographic form, the EPDS, and a questionnaire based on qualitative findings. RESULTS: In the qualitative phase, five themes were identified: individual factors, environmental factors, sociocultural factors, stigma-related factors, and health provider-related factors. In the quantitative phase, the top three barriers were identified as 'household chores being considered women responsibility', 'the burden of household tasks' and 'prioritizing daily responsibilities over mental health'. A positive correlation was found between EPDS scores and factors such as 'lack of reliable childcare optionS', 'relatives dismissing mental distress', 'the burden of household tasks', 'daily life taking precedence over mental health', 'societal expectations of women's roles' and 'spousal indifference or inadequate support during pregnancy and postpartum'. These results highlight how sociocultural and environmental factors significantly influence mental health during the perinatal period. CONCLUSION: In the qualitative phase, five themes emerged: individual factors, environmental factors, sociocultural factors, stigma-related factors, and health provider-related factors. In the quantitative phase, the three highest-scoring questions were primarily related to sociocultural factors. Keywords: Barriers to treatment, perinatal depression, qualitative analysis