Perinatal and infant mental health: equalities impact assessment

Review of academic literature and government report/findings.

Use of national statistics on age and pregnancy as well as deprivation, smoking status, alcohol consumption.

National Statistics

There is strong evidence and policy measures in place across SG that recognise inequalities in age in terms of parenting and perinatal mental health.

There is little specific information in the literature about disability and perinatal mental health. A campaign and report from Engender provided much of the evidence on the impact of physical and learning difficulties on parenting and mental health.

Consultation

The Engender 'Our Bodies, Our Rights' report provides a current perspective on the views of disabled women around their experiences and support made available during pre-conception, pregnancy and after birth, in a Scottish context.

Perinatal mental health predominantly effects woman - because biologically they carry the fetus and give birth. Men can also see worsening mental health in the perinatal period however this would primarily be recognised and treated by adult mental health services. Midwifery, health visiting and GP services will be key in identifying problems and supporting fathers and other primary carers in this period.

There are universal inequalities in women health which are well evidenced and these should be taken in to consideration.

National Statistics

The policy target population is women however fathers/partners are recognised as an intergral part of familial unit so are included in our policies.

n/a - pregnancy is a part of the perinatal period therefore this characteristic had no discrimination potential.

There is a gap in evidence around gender assignment and perinatal mental health.

The current need for evidence on this is unknown due to the rarity of this issue to date.

There is some academic literature around mental health in lesbian mothers, indicating that they are more prone to mental health problems due to discrimination about their sexuality. However, there are indications that lesbian women tend to have planned pregnancies and a strong support from their partner.

National Statistics

It would be beneficial to engage more with some Scottish LGBTQ equalities groups to discuss how sexual orientation can impact people's perinatal mental health. Literature is limited to lesbian mothers and focuses on planned pregnancies in stable relationships. Engagement with youth LGBTI groups would also be beneficial in understanding the overlap of age and sexual orientation in regard to perinatal mental health. Additionally there is little evidence for male same-sex couples and mental health problems in the perinatal period. Overall, this is an area where more evidence is needed.

Ethnicity and perinatal mental health are not well understood. The literature suggests that ethnicity and perinatal mental health depends on the peer/community network around the individual and it would be difficult to categorise ethnic minority groups as more or less at risk of poor perinatal mental health. Ensuring equity of access across ethnic minorities may be the most pertinent way forward, with one key barrier being communication. Peer support has been identified as particularly effective in supporting ethnic minority groups in the perinatal period.

Equalities Team advised no known evidence is available

Engagement with large urban health boards on their experience of engaging with ethnic minorities around perinatal mental health would provide a better evidence base around what the hubs of ethnic minorities in Scotland need.

Investigating which services ethnic minority groups find most acceptable to them would help to ensure policy is supporting them properly.

There is no evidence that indicates one religious group are at heightened risk of developing perinatal mental health problems, or mental health conditions in general. Specific cultural practices can be a barrier to people accessing the services they In some cases, depression is not a recognised condition and therefore providing people with the right support can be challenging.

None for religion.

Cultural beliefs like sitting the month, could impact negatively on access to mental health services and identification of poor mental health in the perinatal period. More information the prevalence of practices like this would help to indicate if more any special measures are needed but this could be included in our evidence gathering for ethnic groups.

n/a