Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town.
Afr J Prim Health Care Fam Med. 2020 May 28;12(1):e1-e9. doi: 10.4102/phcfm.v12i1.2279.
Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child.
The study aimed to explore the barriers and facilitators to service access for adolescents in low-resource settings.
We interviewed 12 adolescents, aged 15-19 years, from low-resource settings in Cape Town, South Africa. Participants had previously engaged with a mental health service, integrated into maternity care.
Twelve semi-structured, individual interviews were used for this qualitative study. Interviews were recorded, transcribed and coded. A framework analysis was employed for data analysis.
Adolescents perceived considerable stigma around both teenage pregnancy and mental illness, which inhibited use of mental health services. Other barriers included fearing a lack of confidentiality as well as logistical and environmental obstacles. Service uptake was facilitated by support from other adults and flexible appointment times. Face-to-face individual counselling was their preferred format for a mental health intervention.
Several key components for adolescent-friendly mental health services emerged from our findings: integrate routine mental health screening into existing obstetric services to de-stigmatise mental health problems and optimise screening coverage; coordinate obstetric and counselling appointment times to rationalise the use of limited resources; and sensitise care providers to the needs of adolescents to reduce stigma around adolescent sexual activity and mental illness. A non-judgemental, caring and confidential relationship between counsellors and clients is crucial for successful interactions.
孕妇和产后青少年是常见精神障碍（CMD）的高危人群；然而，她们接受心理健康服务的参与度和保留率都很低。CMD 对母亲和孩子都有负面后果。
本研究旨在探讨资源匮乏环境中青少年获得服务的障碍和促进因素。
我们采访了来自南非开普敦资源匮乏环境中的 12 名 15-19 岁的青少年。这些参与者之前曾接触过一项纳入产妇保健的心理健康服务。
本定性研究采用了 12 次半结构化的个体访谈。访谈进行了录音、转录和编码。采用框架分析法进行数据分析。
青少年认为少女怀孕和精神疾病都存在很大的耻辱感，这阻碍了他们使用心理健康服务。其他障碍包括担心缺乏保密性以及后勤和环境障碍。获得服务的促进因素包括得到其他成年人的支持和灵活的预约时间。面对面的个体咨询是他们首选的心理健康干预形式。
我们的研究结果提出了一些关键的青少年友好型心理健康服务组成部分：将常规心理健康筛查纳入现有的产科服务，以消除对心理健康问题的污名化并优化筛查覆盖范围；协调产科和咨询预约时间，以合理利用有限资源；并使护理提供者对青少年的需求敏感，以减少对青少年性行为和精神疾病的污名化。咨询师与客户之间没有评判、关怀和保密的关系对成功的互动至关重要。
