Pregnant women's mental health literacy and perceptions of perinatal mental disorders in the Western Cape, South Africa

Abstract

IntroductionLow levels of mental health literacy (MHL) have been identified as a significant treatment barrier. However, little is known about how pregnant women perceive mental disorders during this time, particularly in low- and middle-income countries such as South Africa. Materials and methods262 pregnant women attending antenatal care at a Midwife and Obstetrics Unit (MOU) were recruited to participate. Participants were presented with one of five vignettes, depicting a perinatal woman with a DSM-5 defined mental disorder, including ante- and postnatal depression, panic disorder, substance dependence and schizophrenia. Participants were asked to provide a diagnosis and completed two scales assessing aspects of MHL. ResultsThree quarters of respondents (77.4%) did not identify the signs and symptoms described in the vignettes as those consistent with a mental disorder. More than half (57.5%) viewed the conditions as “typical of a weak character”, while stress was the most widely held explanation for symptoms. Postnatal depression appeared to be perceived as more pathological than antenatal depression. Ability to name mental disorders’ appeared to have little bearing on treatment preference for psychological services as participants were most confident in the therapeutic benefits of consulting with a counsellor or social worker. Notably, seeking help from a spiritual or religious advisor was comparably as popular as seeking help from a psychologist or social worker. DiscussionGiven the elevated prevalence of perinatal mental disorders, these findings are concerning. Developing socio-culturally nuanced understandings of how perinatal mental disorders are perceived is central to the development of successful interventions.