For example, fear of the consequences of accessing services and child removal
“I felt pressure as a Black mum that I’d be judged and not listened to. I was scared my children would be taken away.”
“All the teenagers who died had Children’s Social Services involved with their own children, their children were in care and the women had complex problems involving mental health, substance misuse and domestic abuse.”
Care can be impacted as a consequence of assumptions based on cultural/racial/ethnic/religious bias
“Black women are more likely to have postnatal depression but are less likely to access care or to be referred for follow-up treatment.”
"In Asian culture, girls are expected to become mums and not complain if they do begin to struggle. That’s not right or fair.”
"I am a person... not a checklist! ...Don't judge me before you get to know me... how can I trust you if you are not listening to me? I am so tired of endless meetings about the same topic of inequalities and nothing changes for the Black maternal communities... this is a crisis... who can we talk to, who can help, who really cares?"
Juliyah Brown, Equality, Diversity, and Inclusivity Lead/Research Project Coordinator/Community Facilitator for Croydon BME Forum
“As a young mum you do feel judged a lot…you probably do work harder than most older mums because, you know, we're looking after babies, some of us haven't got a father involved in that, we're trying to get our house. We're trying to look after ourselves.” - Young mum who supported MMHA's young mums project with Children and Young People’s Mental Health Coalition
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Heteronormative and cisnormative assumptions can be harmful for members of the LGBTQ+ community.
Lucy Warwick Guasp, a consultant and trainer working to improve perinatal mental health care for LGBTQ+ parent families, writes:
"Ensuring Perinatal Mental Health services are inclusive of LGBTQ+ people can help remove barriers and anxiety for parents when accessing care. The use of heteronormative and cisnormative language, as well as not seeing yourself reflected in communications (leaflets, literature, websites, systems and policies) can lead to LGBTQ+ people wondering if the service and support is for them.
"Here are some ideas for Perinatal Mental Health services on how they can be more inclusive of LGBTQ+ parents. Look at the use of heteronormative and cisnormative language within your service; avoid making assumptions; maybe use some door opening questions such as ‘Tell me about yourself/selves, how are you both adjusting to parenthood? What pronouns do you use?”
"Are LGBTQ+ parents represented within your communications? Do local LGBTQ+ people know about your service? Engage in education and training to further your knowledge."
This is when you ensure someone receives consistent care from the same healthcare professional or team throughout their treatment. Without this it can make it hard to build trust. It also means someone has to retell their story numerous times.
Read Healthwatch blog about how continuity of care is crucial to addressing perinatal mental health.
About what support is available and likely wait times.
The Royal College of Psychiatrists’ Quality Network for Perinatal Mental Health Services identified in 2021 that only 19% of specialist community services were accessible by public transport.
For example, for those who are first point of contact in a healthcare setting or when an organisation is not trauma-informed (trained in dealing with trauma).
Especially when English isn’t someone’s first language and it’s difficult to get an interpreter.
“Language was identified as one of the main barriers to accessing services outside of this project, and the two organisations facilitated interpretation where in some cases, such as in hospitals, [translation] was inadequate. This is critical to meeting a mother’s rights to consent to care, but also to support wellbeing and stronger transition through the services.” Perinatal Support Project Evaluation: Phase 2 Report – Spring 2023 (University of Nottingham Rights Lab for Hestia and Happy Baby Community)
This includes options for peer support and therapeutic approaches.
See MMHA campaign maps for more on this.
This leads to mistrust and a lack of accountability.
Back to examples of organisations overcoming barriers