How Can This be Less Stressful�: Navigating Supports for Mental Health

Background: Maternal mental health concerns are a leading cause of maternal deaths, a serious public health concern. Suicide, drug overdose, and homicide lead to 1 in 4 maternal deaths. Due to structural racism and other negative determinants of health, Black mothers are at an increased risk of experiencing perinatal mental health concerns, reduced access to services, and adverse maternal and infant outcomes. The legacy of colonization and anti-Black racism contributes to this by maintaining disproportionate cumulative vulnerabilities, experiences with discrimination, and cultural imposition that promote one way of responding to maternal mental health concerns. To move towards (de)colonization, social work researchers must move beyond oppressive practices, negative blame narratives, and the underutilization story for the benefit of the mental health industrial complex. We must create more meaningful spaces through research to learn from the experiences, needs, and preferences of Black mothers, their families, and communities for their collective healing wellness. This oral paper will highlight findings of a qualitative study exploring how Black mothers navigate structural factors and make choices about support for their mental health.

Methods: This qualitative study entailed thematic analysis of in-depth interviews with 12 Black mothers with varied ages (20 to 39), family statuses, education, and income in a midwestern metropolitan community. The interview guide included questions about the intersection of mental health and sources of support (informal, community, and formal mental health). The Consolidated Criteria for Reporting Qualitative Research guided reporting of methods and results.

Results: Three themes revealed will be discussed: changing context in maternal mental health and decision-making, assessing support for mental health, and supporting Black maternal mental health. More specifically, the mothers in this study highlight that their mental health experiences cannot be separated from the ever-changing context in which they live, and the choices they make are grounded in their unique experiences, needs, and preferences. The results also emphasized the role of inadequate care and racial discrimination, the ways in which shared decision-making did not center their preferences, and other barriers. Also, actionable ways to be more helpful and less stressful are shared, such as the necessity to help identify, access, and navigate culturally congruent supports across contexts (e.g., peer support, support groups, mental health coaches, therapists, hotlines). Another solution shared was for more training for social workers and helping professionals to reduce bias and become more helpful, culturally responsive, and respectful in their care.

Conclusions and Implications: The findings provide insights that can guide social work researchers toward more equitable and culturally specific practices and research. Future research could help examine and reimagine universal mental health screening, education, and care policies and practices. Implementation research exploring how perinatal access, community health workers, early childhood, and other programs facilitate ease in access of racially congruent and culturally sensitive supports for mental health across a continuum of care, is also needed. Research centering the experiences and solutions of Black mothers, guides us toward ways to engage in collective action and meaningful change for Black maternal mental health, healing, and wellness.