Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada; Dalla Lana School of Public Health, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
Centre for Addiction and Mental Health, Toronto, ON, Canada.
Res Dev Disabil. 2022 Jul;126:104237. doi: 10.1016/j.ridd.2022.104237. Epub 2022 Apr 26.
Mothers with intellectual disability (ID) experience high rates of mental illness, but these needs are not adequately addressed.
We examined health and social service-provider perceptions of barriers to parenting and mental health care among mothers with ID and strategies for building good practice capacity.
In this qualitative study in Ontario, Canada, we interviewed 13 service-providers working with mothers with ID about their experiences supporting parenting and mental health in mothers with ID, including barriers to services and strategies for building good practice capacity. Data were analyzed via inductive, semantic-level thematic analysis.
Perceived barriers to care provision were the vulnerable social context of women with ID, distrust of "the system" by women with ID, and siloed services. Increased training of service-providers, making accommodations in existing services, and building a community of support for women with ID were offered as strategies for good practice capacity.
Efforts to improve mental health among mothers with ID should focus on improving service-provider capacity and accommodations in existing services, and enhancing coordination of care. WHAT THIS PAPER ADDS?: Mothers with intellectual disability (ID) experience high rates of mental illness, but supports for mothers with ID typically focus on parenting skills, and women's mental health care services do not consider the unique needs of those with ID. Health and social service-providers have reported inadequate training, fragmented services, high caseloads, and lack of practical supports as barriers to providing quality care to mothers with ID. However, no studies have examined service-providers' perceptions of needs related specifically to parenting and mental health among mothers with ID. This study provides new information on barriers to parenting and mental health care among mothers with ID and strategies for good practice capacity, from the perspectives of service-providers. Perceived barriers to care provision include social determinants of health, a distrust of "the system" by women with ID, and siloed services. Providers recommended that providing better training, including accommodations in existing services, and building a community of support could be beneficial to improving practice capacity in the context of mental health care and parenting supports. These factors need to be addressed to improve mental health among mothers with ID.
智障(ID)母亲的精神疾病发病率很高,但这些需求并未得到充分满足。
我们考察了卫生和社会服务提供者对 ID 母亲育儿和精神保健障碍的看法,以及建立良好实践能力的策略。
在加拿大安大略省的这项定性研究中,我们采访了 13 名为 ID 母亲提供服务的服务提供者,了解他们在支持 ID 母亲育儿和精神健康方面的经验,包括服务障碍和建立良好实践能力的策略。数据通过归纳、语义层面的主题分析进行分析。
服务提供的障碍是 ID 妇女脆弱的社会环境、ID 妇女对“系统”的不信任以及服务的分散性。增加服务提供者的培训、在现有服务中做出适应以及为 ID 妇女建立支持社区,被认为是建立良好实践能力的策略。
改善 ID 母亲精神健康的努力应侧重于提高服务提供者的能力和现有服务的适应能力,并加强护理协调。本文增加了什么?智障(ID)母亲精神疾病发病率很高,但对 ID 母亲的支持通常侧重于育儿技能,而女性精神卫生保健服务并未考虑到 ID 人群的独特需求。卫生和社会服务提供者报告称,培训不足、服务分散、工作量大以及缺乏实际支持是向 ID 母亲提供优质护理的障碍。然而,尚无研究专门考察服务提供者对 ID 母亲育儿和精神健康需求的看法。这项研究从服务提供者的角度提供了有关 ID 母亲育儿和精神保健障碍以及建立良好实践能力的策略的新信息。服务提供的障碍包括健康的社会决定因素、ID 妇女对“系统”的不信任以及服务的分散性。提供者建议,提供更好的培训,包括在现有服务中做出适应,以及建立一个支持社区,可能有助于改善精神保健和育儿支持方面的实践能力。需要解决这些因素,以改善 ID 母亲的精神健康。