The United Nations High Commissioner for Refugees (UNHCR) estimates that there are currently 24.5 million refugees and asylum-seekers in the world (UNHCR 2015).
Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease. Mental health among refugees is increasingly being discussed and researchers acknowledge:
Refugees are a vulnerable people.
We have found that uncertain refugee status is a key factor contributing to mental illness in pregnant women. Women with uncertain refugee status are particularly vulnerable to maternal mental illness. Psychological trauma, associated with political conflict, displacement, violence, loss of loved ones, torture, rape and poverty contribute to poorer general maternal health.
For more information see our Issue Brief and for a quick visual overview see our infographic below.
The importance of parental mental health as a determinant of infant and child outcomes is increasingly acknowledged. Yet, there is limited information regarding paternal mental health during the perinatal period. The aim of this review is to summarise existing clinical research regarding paternal mental health in the perinatal period in various contexts, and its possible impact on infant development.
Men are at increased risk of mental health problems during the transition to fatherhood, as well as during the perinatal period. Paternal mental health during the perinatal period has been shown to impact on their child’s emotional and behavioural development. However, research addressing the needs of fathers with mental illness and the impact of their illness on their infant and family has been limited.
A paradigm shift is required, from a focus on women following childbirth and women with pre-existing psychiatric disorders to a broader family perspective with the focus firmly on parent-infant relationships. This paradigm shift needs to involve greater research into the fathering role and paternal mental illness during the perinatal period, including further studies into risk factors, impact on the family system, and the most appropriate form of intervention and service provision.
The full research review is available on Wiley Online Library
In our resource library, you can find information for future fathers in four different languages
Mental ill-health and poverty are closely linked and interact in complex negative cycles
“What interventions are needed to break the cycle of poverty and mental ill health?”
Growing international evidence shows that mental ill health and poverty interact in a negative cycle in low-income and middle-income countries. However, little is known about the interventions that are needed to break this cycle.
The vicious cycle of poverty and mental ill-health Social Selection or Social Drift theory: People with mental illnesses are at increased risk of drifting into or remaining in poverty through increased health expenditure, reduced productivity, stigma, loss of employment and associated earnings.
A UN General Assembly Declaration (A/RES/65/L.27 2010) on global health and foreign policy welcomed the WHO report, and recognized that mental health problems have “huge social and economic costs.” There is growing international evidence that mental ill health and poverty interact in a negative cycle in low-income and middle-income countries.
This cycle increases the risk of mental illness among people who live in poverty, and increases the likelihood that those living with mental illness will drift into or remain in poverty.
Mental health interventions can be associated with improved economic outcomes.
Mental Health interventions can have positive effects on economic status – some poverty alleviation interventions, such as conditional cash transfers and asset promotion programmes, can have mental health benefits.
Related Publications: Integration of mental health into primary care in low- and middle-income countries (PRIME)
Source: PRIME policy brief #1
Inspiring African innovations: Perinatal Mental Health Project, South Africa [#WHD2017 Africa Blog Series]
Suicidal ideation during the perinatal period
Mothers’ emotional needs can go undetected during the perinatal period where there is much attention on the baby. We suggest care providers routinely ask questions about suicidality during mental health or physical health screening.
Our recently produced Issue Brief deals with some of the risk factors and unearths some of the myths surrounding suicide during pregnancy.
Read this and other Issue Briefs on our website
Ever wondered what is considered a suicidal thought, ideation, or gesture? Than read this Explanation of Suicidal Thinking In Plain Mama English by Postpartum Progress
Screening is the entry point to mental health care.
We recently produced an advisory for primary level screening of mothers for depression, anxiety and suicidal ideation and behaviour in South Africa.
When health providers are not necessarily skilled in other forms of detection and when disorders are not clinically obvious, brief screening is a critical step towards providing mental health support for vulnerable women.
Read the recommendations on our website.
Another recent study found that women who underwent regular maternal depression screening are more likely to avail of mental healthcare services before, during and after pregnancy.
Read this related article Maternal Depression Screening Is Causing More Women To Avail Of Mental Healthcare Services
in the Parent Herald
The upcoming documentary “When The Bough Breaks” takes an inside look at postpartum depression and perinatal mood disorders. When actress Tanya Newbould began experiencing postpartum depression, she didn’t know where to turn. She then teamed up with director Jamielyn Lippman to take a closer look at the mental illness that affects one in five new mothers.
Watch the trailer here
“When I first became a mother, I didn’t know about depression. Now I would like to let everyone know about this problem.”
Recently, celebrities like Hayden Panettiere and Drew Barrymore opened up about their struggles with postpartum depression. Some of the moms who are featured in the articles below, have also shared their postpartum depression with the world, despite a cultural stigma against discussing motherhood in less-than-glowing terms.
For this blog, we collated some outstanding stories, studies and guides for everyone who is, was or know someone who might be struggling with depression or anxiety during or after pregnancy.
We recommend you read these fantastic articles and blogs – postpartum moms open up:
- What Is Postpartum Depression? 5 Moms Tell Us About The Darkest Time In Their Lives
- When I first became a mother, I didn’t know about depression. Now I would like to let everyone know about this problem.
- Well melt me in butter and roll me in nuts, this illness will release its clutch
- Intrusive Thoughts – Postnatal Depression – OCD
- Having a baby is beautiful, but postpartum emotions are so hard
- Motherhood myths and postpartum depression
Useful material for care givers, nurses and health workers:
- Postpartum Depression / Postnatal Depression: The Basic Guide to Treatment and Support
- Basic Counselling Skills
- Maternal Mental Health – guide for health and social workers
Related recent research:
- Creating capabilities through maternal mental health Interventions
- Abuse in South African maternity settings is a disgrace: Potential solutions to the problem
- Stepped Care for Maternal Mental Health: A Case Study of the Perinatal Mental Health Project in South Africa
The Perinatal Mental Health Project in South Africa addresses the crisis of mental illness related to pregnancy among women living in adversity.
We are an independent initiative based at the University of Cape Town, located within the CPMH. The PMHP actively addresses the challenges associated with gender based violence, teen pregnancy, HIV, substance misuse, refugee status and early childhood development through its clinical engagement with vulnerable women and their families, through training of staff that interact with these women, through research projects and advocacy work.