Pregnant asylum seekers' perspective on mental health screening: A qualitative study

Psychiatric disorders are prevalent among pregnant asylum seekers and can have adverse effects on both the individual and newborns. There is limited research on the perspectives of pregnant asylum seekers on mental health screening. This study investigates whether pregnant asylum seekers consider the Refugee Health Screener 15 (RHS-15) suitable and acceptable as a mental health screening test.

Eight participants filled out the RHS-15. Semi-structured interviews were conducted in which mental health screening and the acceptability and suitability of the RHS-15 to screen for mental health disorders were discussed. Two researchers performed an inductive thematic analysis.

Three themes were identified: 'Importance of mental health screening', 'Talking about mental health' and 'Use of the RHS-15'. Participants recognized how their past experiences and seeking asylum during pregnancy rendered them more susceptible to mental health conditions. Screening was considered important since participants valued talking about mental health with their midwife, but they would not initiate this conversation. Barriers and enablers to these discussions included a language barrier, cultural differences, family support, practical barriers, relationship with healthcare providers and limited access to and unfamiliarity with the Dutch healthcare system. Our participants considered the RHS-15 a suitable instrument for mental health screening.

Pregnant asylum seekers are often marginalized and underserved and experience high rates of psychiatric disorders. Our participants considered mental health screening in the perinatal period acceptable and necessary. Further research should focus on the implementation of the RHS-15 as a screening tool for perinatal care in this population.