Singla Daisy R, Meltzer-Brody Samantha, Savel Katarina, Silver Richard K
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
Front Psychiatry. 2022 Feb 7;12:826019. doi: 10.3389/fpsyt.2021.826019. eCollection 2021.
There is a call to action to reduce the public health burden of perinatal depression worldwide. The COVID-19 pandemic has further highlighted significant gaps in perinatal mental health care, especially among women who identify as Black, Indigenous, People of Color (BIPOC). While psychotherapeutic (cognitive, behavioral and interpersonal) interventions are endorsed for perinatal mood disorders, barriers to access and uptake contribute to inequitable access to treatment at the population level. To effectively address these barriers and increase the scalability of psychotherapy among perinatal women, we suggest four pragmatic questions to be answered from a patient-centered lens; namely, "who," "what," "how," and "when." Promising avenues include task-sharing among mental health non-specialists, an emphasis on culturally sensitive care, web-based delivery of psychotherapy with some caveats, and a lifespan approach to perinatal mental health. Innovative research efforts are seeking to validate these approaches in diverse contexts across North America and the UK, lending optimism toward scalable and long-term solutions for equitable perinatal mental health care.
全球范围内正在呼吁采取行动减轻围产期抑郁症对公共健康的负担。新冠疫情进一步凸显了围产期心理健康护理方面的重大差距,尤其是在那些自认为是黑人、原住民、有色人种(BIPOC)的女性中。虽然心理治疗(认知、行为和人际)干预被认可用于治疗围产期情绪障碍,但获得治疗和接受治疗的障碍导致在人群层面上治疗的不公平获取。为了有效解决这些障碍并提高心理治疗在围产期女性中的可扩展性,我们建议从以患者为中心的角度回答四个务实的问题;即“谁”、“什么”、“如何”和“何时”。有前景的途径包括心理健康非专科人员之间的任务分担、强调文化敏感护理、在有一些注意事项的情况下通过网络提供心理治疗,以及采用围产期心理健康的全生命周期方法。创新的研究工作正在寻求在北美和英国的不同背景下验证这些方法,为实现公平的围产期心理健康护理的可扩展和长期解决方案带来了乐观的前景。