A pilot investigation conducted in the community agency examined the current referral activities for women screened with high levels of postpartum depression symptoms in two ways: 1) focus groups were conducted with agency staff and 2) systemic data gathering of agency's current referral practices.
Three focus groups with 16 agency staff were conducted to examine practices, barriers and successes in mental health referrals for depressed women. The transcripts of the focus groups were analyzed through content analyses by three coders and the use of QSR NVivo 8. All coders coded each transcript independently and completed open coding of units of analysis, identified initial categories and engaged in comparative analysis.
The following themes emerged from the analysis: social support, life events, culture & language, continuity of care and mental health stigma. One important finding pertaining to social support is the suspicion with which many low income women view the mental health system and the time it takes to develop a trusting relationship. The postpartum women experience frequent life stressors and as a result the staff find it difficult to distinguish between a depressive disorder and a normal reaction to stress. In addition, these stressors make it harder to engage a postpartum mother into mental health treatment. Cultural taboos, translation of different languages and immigration issues all need to be navigated. Other findings, including facilitators of the referral process and implications of the findings for developing strategies for increasing referral completion will be discussed.
An examination of the referral process for PPD is critical to the field of social work as few women who need mental health treatment are following through on referrals. PPD affects not only women but their children, families and communities as well. Identifying barriers and facilitating factors to increase the likelihood of postpartum women seeking the treatment they need can impact long-term outcomes for both the women and their children.