Family physicians perceived role in perinatal mental health: an integrative review

Noonan, Maria; Doody, Owen; Jomeen, Julie; O’Regan, Andrew; Galvin, Rose

Abstract

Background: Responding to and caring for women who experience mental health problems during the perinatal
period, from pregnancy up to one year after birth, is complex and requires a multidisciplinary response. Family
physicians are ideally placed to provide an effective response as it is recognised that they are responsible for
organising care and supports for women and their families. This paper reports an integrative review undertaken to
examine family physicians’ perceived role in perinatal mental health care and concludes with recommendations for
health policy, research and practice.
Method: A systematic search of literature in seven databases from January 2000 to March 2016 identified a total of
1125 articles. Qualitative, quantitative and mixed-method studies were eligible for inclusion if they explored family
physicians’ experiences of caring for women who experience perinatal mental health problems.
Results: Thirteen articles reporting 11 studies met the inclusion criteria for this review and quality of included
studies were assessed using published criteria for the critical appraisal of qualitative and quantitative research
methods. Cross-study narrative syntheses of quantitative and qualitative findings are presented under three themes:
identification of perinatal mental health problems, management of perinatal mental health problems and barriers to
care provision. While family physicians recognise their role in relation to perinatal mental health the collective
interpretation revealed that; they receive variable levels of preparation for this role, no consistent approach to
screening exists, pharmacological management of mood disorders is the main treatment modality and limited
access to specialist perinatal mental health services exists which impacts on pharmacology decisions.
Conclusion: Family physicians require timely access to local integrated care pathways that provide a wide range of
services that are culturally sensitive, perinatal mental health specific, support psychological well-being and infant/
family mental health. Family physicians are open to incorporating a brief validated screening tool into primary
practice supported by succinct guidelines. Research that examines training needs in relation to perinatal mental
health could be used to inform family physician training programmes and curriculum development around
perinatal mental health.
Keywords: Integrative review, Family physician, General practitioner, Perinatal mental health, Postpartum
depression, Screening, Referral pathways, Integrated services

Citation

Noonan, M., Doody, O., Jomeen, J., O’Regan, A., & Galvin, R. (2018). Family physicians perceived role in perinatal mental health: an integrative review. BMC family practice, 19(1), Article 154. https://doi.org/10.1186/s12875-018-0843-1

• Journal Article Type: Article
• Acceptance Date: Feb 5, 2018
• Online Publication Date: Sep 8, 2018
• Publication Date: 2018-12
• Deposit Date: Feb 15, 2019
• Publicly Available Date: Feb 18, 2019
• Journal: BMC Family Practice
• Print ISSN: 1471-2296
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 1
• Article Number: 154
• DOI: https://doi.org/10.1186/s12875-018-0843-1
• Keywords: Family Practice
• Public URL: https://hull-repository.worktribe.com/output/1304856
• Publisher URL: https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-018-0843-1