Navarrete Laura, Lara Ma Asunción, Berenzon Shoshana, Mora-Rios Jazmin
Directorate of Epidemiological and Psychosocial Research, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico.
Doctorate Program in Medical, Odontology and Health Sciences of the National Autonomous, University of Mexico, Mexico City, Mexico.
Int J Womens Health. 2022 Dec 6;14:1667-1679. doi: 10.2147/IJWH.S381196. eCollection 2022.
Perinatal depression is a common mental disorder regarded as a severe public health problem. Studies have shown that incorporating mental health care into primary health services that provide pregnancy care makes it easier for women to seek help for depressive symptoms. In this context, the following question is of interest: How prepared are primary health services in Mexico City that provide pregnancy and postpartum care to treat perinatal depression? This article seeks to explore the perceptions and knowledge of perinatal depression in health professionals and analyze the barriers to its care at primary care centers in Mexico City.
An exploratory study with a qualitative approach was conducted. Doctors, nurses, social workers who provide maternal and childcare, mental health personnel, and the directors of four centers were interviewed. Interviews were audio-recorded and transcribed for thematic analysis.
Most primary care personnel are unaware of the Official Standard that recommends providing maternal mental health care during the perinatal period. There is no initiative for its incorporation into routine care. A significant barrier to its implementation is health professionals' biased, stereotyped perception of perinatal depression, motherhood, and the role of women. Other barriers include the workload of health professionals, the division of care between professionals, and the lack of communication between the latter. Women with psychological symptoms are not referred to mental health staff in a timely manner. Social workers are in closer contact with women and are more willing to address their emotional distress.
Maternal mental health care, contingent on pregnancy, childbirth, and puerperium care at primary care centers is currently not possible due to the lack of knowledge, barriers, and directors' dependence on hospital management decisions.
围产期抑郁症是一种常见的精神障碍，被视为严重的公共卫生问题。研究表明，将心理健康护理纳入提供孕期护理的初级卫生服务中，会使女性更容易就抑郁症状寻求帮助。在此背景下，以下问题值得关注：墨西哥城提供孕期和产后护理的初级卫生服务机构在治疗围产期抑郁症方面准备得如何？本文旨在探讨卫生专业人员对围产期抑郁症的认知和了解，并分析墨西哥城初级保健中心在护理该疾病方面的障碍。
采用定性研究方法进行探索性研究。对提供母婴护理的医生、护士、社会工作者、心理健康人员以及四个中心的主任进行了访谈。访谈进行了录音并转录以进行主题分析。
大多数初级保健人员并不知晓推荐在围产期提供孕产妇心理健康护理的官方标准。没有将其纳入常规护理的举措。其实施的一个重大障碍是卫生专业人员对围产期抑郁症、母亲身份和女性角色存在偏见和刻板的认知。其他障碍包括卫生专业人员的工作量、专业人员之间护理工作的划分以及他们之间缺乏沟通。有心理症状的女性没有及时被转介给心理健康工作人员。社会工作者与女性联系更紧密，更愿意处理她们的情绪困扰。
由于缺乏相关知识、存在障碍以及中心主任依赖医院管理决策，目前在初级保健中心基于怀孕、分娩和产褥期护理提供孕产妇心理健康护理不太可能。
