Help-seeking for moderate to severe perinatal depression in Nigeria: Implications for a cultural-ecosocial approach to global mental health

Perinatal depression is a major public health problem that is under-treated in low- and middle-income countries, with negative community attitudes often cited as a major barrier to help-seeking and treatment. In this paper, we investigate help-seeking for perinatal depression, some of whom may have...

Full description

Saved in:
Bibliographic Details
Main Authors: Ademola Adeponle (Author), Danielle Groleau (Author), Oye Gureje (Author), Laurence J. Kirmayer (Author)
Format: Book
Published: Elsevier, 2023-12-01T00:00:00Z.
Subjects:
Online Access:Connect to this object online.
Tags: Add Tag
No Tags, Be the first to tag this record!

MARC

LEADER 00000 am a22000003u 4500
001 doaj_10cfe3eb6e3e4731b08ee9a2addbacd1
042 |a dc 
100 1 0 |a Ademola Adeponle  |e author 
700 1 0 |a Danielle Groleau  |e author 
700 1 0 |a Oye Gureje  |e author 
700 1 0 |a Laurence J. Kirmayer  |e author 
245 0 0 |a Help-seeking for moderate to severe perinatal depression in Nigeria: Implications for a cultural-ecosocial approach to global mental health 
260 |b Elsevier,   |c 2023-12-01T00:00:00Z. 
500 |a 2666-5603 
500 |a 10.1016/j.ssmmh.2023.100217 
520 |a Perinatal depression is a major public health problem that is under-treated in low- and middle-income countries, with negative community attitudes often cited as a major barrier to help-seeking and treatment. In this paper, we investigate help-seeking for perinatal depression, some of whom may have experienced psychosis in the context of perinatal depression, and its cultural shaping in Nigeria. Our approach was informed by cultural constructivist and critical anthropological perspectives to situate perinatal depression in ecosocial context with systematic attention to the social-structural determinants. Help-seeking was controlled by caregivers, but patients and caregivers differed in their definitions of illness onset: caregivers focused on violation of norms for maternal behavior, whereas patients focused on somatic and psychological distress. Help-seeking entailed use of two different reasoning approaches. The default approach was ad-hoc and contingency-based, depending on: 1) the kinds of help immediately available and the fit with experiential knowledge; 2) the meanings of the patient's problem as negotiated in social interactions; 3) concerns about stigma that led to secrecy in seeking help; and 4) the perceived degree of immediate risk to safety. The second approach involved more explicit deliberation and took over in situations of uncertainty including: 1) worsening or unremitting illness despite treatment; 2) harm from treatment; and 3) perceived inadequacy of a treatment to bring about healing. Avoiding mental illness stigmatization was seen as dependent on limiting public awareness of the individual's affliction. The meanings of illness were locally informed and negotiated in ongoing social interactions and practices of social recognition and status negotiation that legitimated illness and influenced help-seeking. Clarifying the social context of mental health problems and identifying cultural and structural risk and protective factors can inform the design of health care systems to improve access to care and the development of culturally appropriate and effective intervention programmes. 
546 |a EN 
690 |a Perinatal depression 
690 |a Nigeria 
690 |a Help-seeking 
690 |a Stigma 
690 |a Women's agency 
690 |a Mental healing 
690 |a RZ400-408 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n SSM - Mental Health, Vol 3, Iss , Pp 100217- (2023) 
787 0 |n http://www.sciencedirect.com/science/article/pii/S2666560323000324 
787 0 |n https://doaj.org/toc/2666-5603 
856 4 1 |u https://doaj.org/article/10cfe3eb6e3e4731b08ee9a2addbacd1  |z Connect to this object online.