‘Big disparities’: why black mothers in England are more at risk of perinatal mental illness
Perinatal mental health conditions affect more than a quarter (27%) of new and expectant mothers across England and include a range of conditions including postpartum depression and postpartum psychosis. A Guardian analysis of NHS figures has found that in cases of perinatal mental illness leading to hospital admissions, black patients are more than twice as likely to be admitted as their white counterparts.
Part of the reason why black mothers are at greater risk for perinatal mental illness is because black people in general are at greater risk for mental illness.
In England, black people are more than four times more likely to be detained under the Mental Health Act, and more than ten times more likely to be subject to a community order.
Dr. Lade Smith, the president of the Royal College of Psychiatrists, said this was because factors such as “poverty, housing insecurity and discrimination increase the risk of all mental disorders”.
She added: “If you are black you are at greater risk of being socially disadvantaged and this means you are also more likely to suffer from mental illness.”
Sandra Igwe, the founder of the Motherhood Groupan organization dedicated to supporting black maternal health, said the stigmas surrounding mental health, as well as racism, could play a role in the inequality.
The Motherhood Group organizes support groups, workshops and works with NHS trusts to deliver cultural competency training for black maternal healthcare.
“Many of the mothers we work with have shared how they often feel unseen, unheard and misunderstood by healthcare providers,” says Igwe. “There may be cultural stigmas around mental health care that make it more difficult to seek help.
“Black women also disproportionately experience stressors such as the weight of systemic racism. All of this reinforces the already overwhelming transition to motherhood.
“There also needs to be a more open and honest dialogue to break down the stigmas that persist in our communities. We need to normalize talking about maternal mental health and seeking help. Black mothers should feel empowered and supported, not ashamed and alone.”
Dr. Katie Marwick, a senior clinical research fellow at the University of Edinburgh and honorary consultant psychiatrist at NHS Lothian whose research areas include perinatal mental illness and psychiatry, said the increased frequency of admissions in black women in the six weeks after giving birth was driven by stigma, but also the fact that women from minority ethnic backgrounds are less likely to have access to perinatal services in the community and are therefore more likely to be present at a crisis point.
“It is well known that psychotic disorders are more common in people who have emigrated to Europe, or in their children, especially black people,” Marwick said.
“This does not reflect an increased risk of psychosis in people of that ethnicity, wherever they live. It has to do with moving to another country and can be caused by language barriers and social disadvantage. Although the perinatal period has been little studied to date, it is likely that there is also an increased risk of psychotic disorders for black women during this period.”
She added that this could be due to access to services. “Ethnic minority women may be unaware of or avoid accessing services, and this is sometimes related to experiencing negative attitudes or cultural insensitivity from professionals and feeling rejected,” she said.
“All these factors can lead to women coming to services later with more severe symptoms.”
Dr. Nicole Votruba, a senior research fellow at the Nuffield Department of Women’s and Reproductive Health, said research shows “major disparities” remain for women from minority ethnic groups in accessing and receiving perinatal mental health care in Great Britain. -Britain. socio-economic factors and stigma.
She added: “Stigma is a major barrier, meaning women may not be able to seek or receive the support they need, or in the way they need it. For example, women may be afraid to reveal their mental health problems for fear of appearing inadequate as mothers. And socio-economic inequalities and cultural and language barriers often exacerbate the mental health gap for women from ethnic minority groups.”
“The Women’s Health Strategy for England has highlighted the need to tackle these inequalities. We need to better understand what happens during a woman’s journey, from the onset of her mental health problems to her admission to hospital.
“How can we support women from ethnic minority groups to access perinatal mental health care in their communities? How can we develop community services that are culturally sensitive, to support women early and help prevent the onset of more serious perinatal mental health conditions.”