Abstract
Objectives: Mental disorders are vastly underdiagnosed in low-income countries that disproportionately affect women. We aimed to evaluate the prevalence of common mental disorders in newly postpartum women, and stigma associated with mental health reporting in an Ethiopian community using a validated World Health Organization survey.Methods: The Self Reporting Questionnaire (SRQ) for psychological distress was administered in Amharic by nurses to 118 women aged 18–37 years who had given birth in the prior 3 months in the Glenn C. Olsen Memorial Primary Hospital in Yetebon. Mental health stigma among the four nursing staff was assessed using Link and Phelan's Components of Stigma.Results: Among 118 women surveyed, 18% had a probable common mental disorder using the SRQ 4/5 cutoff and 2% admitted to suicidal thoughts. Presence of stigma in the healthcare staff was verified, including labeling, stereotyping, separating, and status loss and discrimination.Conclusion: Postpartum mental health disorders as well as stigma against such diagnoses are common in the Yetebon community. There is an urgent need for increased availability of properly trained and supervised healthcare staff in the identification and referral of postpartum women with common mental disorders.
Highlights
Identification and treatment of mental illness in most African countries, including Ethiopia, remains scarce
After obtaining verbal, informed consent, nurses administered the survey to the women as part of their postpartum checkup, including basic sociodemographic information at the beginning of the survey, to learn if they had experienced any psychological distress or postpartum depressive symptoms, and whether they were willing to discuss their emotions. Given that this was the first time that mental health was addressed at this hospital, we focused data collection on the Self Reporting Questionnaire (SRQ) and minimized other data collection
The main objectives of this research were to determine the prevalence of postpartum common mental disorders in the rural community of Yetebon, and to assess whether stigma existed in the health care staff and community that could potentially bias the identification of women with psychological distress
Summary
Identification and treatment of mental illness in most African countries, including Ethiopia, remains scarce. An estimated 20% of postpartum women in low-income countries suffer from common mental disorders, including depression and anxiety; a systematic review confirmed the prevalence of perinatal common mental disorders in Africa to be 18–19% (Sawyer et al, 2010). Maternal Mental Health in Ethiopia disorders include a number of social dimensions such as being unmarried, marital conflict, family conflict, poverty, and lack of social support (Sawyer et al, 2010; Fisher et al, 2012). The United Nations adopted global Sustainable Development Goals in 2015 that for the first time include a commitment (Target 3.4) to “by 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being” (UN General Assembly, 2015). The WHO has intensified its focus on mental health, calling, for example, for an end to the chaining of people with mental illness (WHO, 2011; Jack et al, 2014)
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