Perinatal Mental Health Care in Switzerland

Depression Clinical Trial

— MADRE  

Official title:

Perinatal Mental Health Care in Switzerland: Unraveling the Perspectives of Affected Women and Health Professionals

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04185896
• Other study ID #: 2218-2018
• Status: Recruiting
• Start date: July 10, 2019
• Est. completion date: February 29, 2020

Study information

• Verified date: December 2019
• Source: Bern University of Applied Sciences
• Contact: Anke Berger, Dr.
• Phone: +41318483543
• Email: anke.berger[@]bfh.ch
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This qualitative study with quantitative elements examines the health care provided to women who suffered from mental disorder during pregnancy and / or in the first year after birth (i.e. during the perinatal phase). Investigators will perform individual interviews with former PMD patients, and health and social care professionals to gain insights into current health care for PMD patients.

Description:

Background: Perinatal mental disorders (PMD) are highly prevalent (up to 20%), and patients use mental health care at high rates (Berger et al 2018). It is not known if the health care for PMD patients meets the needs of the patients.

Aim: The Investigators will identify factors that promote or hinder service provision and access to care, for a range of relevant PMD. The investigation will cover the user and provider perspectives.

Methods: The qualitative study consists of two complementary parts to assess user and provider perspectives. In part 1 the Investigators will conduct individual semi-structured interviews with 24 women who have had PMD. The sample will comprise of 4 clusters of relevant ICD-10 F-diagnoses, covering a wide range of mental disorders. The sample will also comprise of participants who received or did not receive mental health care before the last pregnancy. In part 2, the Investigators perform 3 focus groups (with 6-8 participants per group) with health and social care professionals, and a health-insurance delegate, to collect their experiences and perspectives on perinatal health care for PMD patients. The Investigators are guided for data collection and analysis by Levesque's et al (2013) conceptual model on access to health care.

Expected results: The study will identify barriers and facilitators for health care access (user perspective) and provision (provider perspective). The study will generate the evidence base needed to develop integrated, coordinated, patient- and family-centered care for patients with various types of PMD.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 24
• Est. completion date: February 29, 2020
• Est. primary completion date: February 29, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Sample 1: patients with former PMD

Inclusion criteria:

1. PMD within the past 24 months before the interview,

2. Recovered from acute PMD and stable for at least 12 months before the interview;

3. Able to share experiences;

4. More than 18 years old

5. Speak and understand German

6. At least 1 diagnosis in the last perinatal phase out of 4 groups of psychiatric disorders (ICD-10 Chapter V, F00-F99):

1. Mood (affective) disorders (F30-F39); Anxiety disorders (F41); Reaction to severe stress, and adjustment disorders (F43); and Obsessive-compulsive disorder (F42);

2. Disorders of adult personality and behavior (F60-F69; especially F60.3 Emotionally unstable personality disorder);

3. Mental and behavioral disorders due to psychoactive substance use (F10-F19; excluding tobacco (F17) if it is the sole F-diagnosis of the patient);

4. Psychosis (F20-F29 Schizophrenia, schizotypal and delusional disorders).

Exclusion criterion: Current pregnancy

Sample 2: Professional health and social care providers

Inclusion criteria:

1. Professional experience of at least two years,

2. Have cared for at least 2 PMD patients the year before the focus group, a

3. Speak and understand German.

Related Conditions & MeSH terms

• Adaptation Reaction
• Anxiety Disorders
• Behavior Disorders
• Depression
• Disease
• Health Care Acceptability
• Health Care Seeking Behavior
• Health Care Utilization
• Mental Disorder
• Mental Disorders
• Panic Disorder
• Perinatal
• Post Traumatic Stress Disorder
• Psychosis
• Stress Disorders, Post-Traumatic
• Stress Disorders, Traumatic
• Substance Abuse
• Substance-Related Disorders

Locations

Country	Name	City	State
Switzerland	Anke Berger	Bern

Sponsors (2)

Lead Sponsor	Collaborator
Bern University of Applied Sciences	University of Bern

Country where clinical trial is conducted

Switzerland, 

References & Publications (1)

Berger A, Bachmann N, Signorell A, Erdin R, Oelhafen S, Reich O, Cignacco E. Perinatal mental disorders in Switzerland: prevalence estimates and use of mental-health services. Swiss Med Wkly. 2017 Mar 7;147:w14417. doi: 10.4414/smw.2017.14417. eCollection 2017. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Narratives of barriers to perinatal mental health care use	Narratives of access-inhibiting factors, in semi-structured individual interviews with former PMD patients	perinatal phase, i.e. pregnancy and first year after birth
Primary	Narratives of mentions of facilitators of perinatal mental health care use	Narratives of access-promoting factors, in semi-structured individual interviews with former PMD patients	Perinatal phase, i.e. pregnancy and first year after birth
Primary	Narratives of mentions of barriers to perinatal mental health care provision	Narratives of provision-inhibiting factors, in focus group interviews with health and social care providers	Perinatal phase, i.e. pregnancy and first year after birth
Primary	Narratives of mentions of facilitators of perinatal mental health care provision	Narratives of provision-promoting factors, in focus group interviews with health and social care providers	Perinatal phase, i.e. pregnancy and first year after birth
Secondary	Sociodemographic data of participating affected PMD patients	Sociodemographic data of participating affected PMD patients	2019-2020
Secondary	Sociodemographic data of participating health care professionals	Sociodemographic data of participating health care professionals	2019-2020