Abstract

FIELD, Sally; ABRAHAMS, Zulfa  and  HONIKMAN, Simone. Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa. Afr. j. prim. health care fam. med. (Online) [online]. 2020, vol.12, n.1, pp.1-9. ISSN 2071-2936.  http://dx.doi.org/10.4102/phcfm.v12i1.2279.

BACKGROUND: Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child. AIM: The study aimed to explore the barriers and facilitators to service access for adolescents in low-resource settings. SETTING: We interviewed 12 adolescents, aged 15-19 years, from low-resource settings in Cape Town, South Africa. Participants had previously engaged with a mental health service, integrated into maternity care. METHODS: Twelve semi-structured, individual interviews were used for this qualitative study. Interviews were recorded, transcribed and coded. A framework analysis was employed for data analysis. RESULTS: Adolescents perceived considerable stigma around both teenage pregnancy and mental illness, which inhibited use of mental health services. Other barriers included fearing a lack of confidentiality as well as logistical and environmental obstacles. Service uptake was facilitated by support from other adults and flexible appointment times. Face-to-face individual counselling was their preferred format for a mental health intervention. CONCLUSION: Several key components for adolescent-friendly mental health services emerged from our findings: integrate routine mental health screening into existing obstetric services to de-stigmatise mental health problems and optimise screening coverage; coordinate obstetric and counselling appointment times to rationalise the use of limited resources; and sensitise care providers to the needs of adolescents to reduce stigma around adolescent sexual activity and mental illness. A non-judgemental, caring and confidential relationship between counsellors and clients is crucial for successful interactions.

Keywords : adolescents; maternal mental health; service uptake; barriers to care; facilitators to care; qualitative; depression.

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