On International Woman’s Day 2014, new research from the Race Equality Foundation shows how the UK is failing to adequately respond to the mental health needs of our country’s increasingly diverse pregnant women and new mothers.
The diversity of motherhood in the UK is increasing steadily, due in part to higher fertility rates among migrant women, indicating that they will soon become some of the main users of maternity services. In a new piece of research, Zahira Latif examines why migrant women appear to have an unusually low take-up of mental health support services when they are pregnant or new mothers, and argues that an inappropriate emphasis on “Western-centric” diagnostic tools could be part of the problem.
The little research that exists on this subject point to two main factors that impede and prevent diagnosis and treatment of problems such as Post Natal Depression (PND) in migrant women: the cultural and the practical.
While cultural factors include the fear of being stigmatised by families and communities, which may prevent women from disclosing their feelings, mental health services may also be failing to provide appropriate support, employing tools tailored to the needs of Western populations that depend on women self-reporting their symptoms to practitioners. In cultures where there is little understanding and awareness of maternal mental health related illnesses, women can struggle to identify symptoms or may even lack the language to express them.
It has been found that the Edinburgh Postnatal Depression Scale (EPDS), for example, which is used to screen for PND, does not have cultural congruence for all ethno-cultural groups. Research also shows that women from non-Western cultures are more likely to present physical symptoms resulting from mental health related conditions such as depression.
Practical barriers to health services may include language difficulties and a limited understanding of how and where to seek help. Poverty and a lack of social support are problems commonly encountered by migrant women, and these are only exacerbated during and postnatal period.
Women who have left their countries by force may be the most vulnerable because they are often separated from their families, have limited knowledge of the English language, are visible minorities, and are often in uncertain immigration categories. Those who claim asylum must deal not only with an, at times, baffling and bureaucratic system, but also with the practical and psychological challenges of restarting a new life in a new country, often after fleeing sexual violence, war, domestic violence, female genital mutilation, forced abortion or sterilisation.
In a review of current mental health provision for pregnant and postnatal migrant women, the 2010 National Perinatal Mental Health Project found that service providers feared that they were ill-equipped to manage the range of diversity and complexity of migrant women’s needs which they encountered. The study found an urgent need to provide training for healthcare professionals to ensure that they were able to work with mothers from diverse population groups.
Jabeer Butt, Deputy Chief Executive of the Race Equality Foundation says:
“We welcome this new briefing paper and second its calls for further research and service provision for migrant women. For one day a year, we turn our attention specifically to the needs of women the world over. There is an urgent need to ensure that this focus includes making cultural provisions for our country’s next generation of mothers.”
The Race Equality Foundation is a national charity that promotes race equality in social support (what families and friends do for each other) and public services (what ‘workers’ do with people who need support). We do this by:
- exploring what is known about discrimination and disadvantage
- developing evidenced-based better practice to promote equality
- disseminating better practice through educational activities, conferences, written material and websites.