Health visitors’ experiences of assessing perinatal mental health and psychotic like experiences in new mothers: a thematic analysis.

Riley, Hannah and Sellwood, Bill and Chamberlain, Elizabeth (2024) Health visitors’ experiences of assessing perinatal mental health and psychotic like experiences in new mothers: a thematic analysis. PhD thesis, Lancaster University.

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Abstract

The thesis presented includes a systematic literature review, an empirical research paper and a critical appraisal with wider reflections on the project. In Chapter One, a systematic literature review exploring the impact of birth trauma on mother-infant attachment is outlined. A systematic search identified 18 quantitative studies which were subject to narrative synthesis and PRISMA guidelines. Results were mixed, however, more studies than not found associations between childbirth trauma and the attachment relationship. The findings are discussed in relation to the wider research around birth trauma and attachment. Further research looking at the direction of causality is recommended. Chapter Two reports on the empirical research paper which aimed to gain an in-depth understanding of health visitors’ knowledge and experiences of assessing mental health, particularly psychotic like phenomena in new mothers. Ten UK health visitors participated in individual semi-structured interviews and transcripts were subject to reflexive thematic analysis. Three overarching themes were identified: ‘Engagement with mental health’, ‘Dilemmas around psychotic-like-experiences’ and ‘Impact of disclosure’. The data found health visitors’ were confident with assessing new mothers’ postnatal mental health, however this was limited regarding psychosis. Implications for perinatal services and training for health visitors are discussed, in relation to providing support for new mothers affected by psychotic-like symptoms. Chapter Three incorporates a critical appraisal which provides a reflective overview of the project. It also includes a critical review of the literature review and empirical paper alongside clinical implications for the findings from these papers.