Legal interventions for perinatal depression in India: a qualitative study with clinical specialists having expertise in perinatal mental health.

Abstract

Objectives: To provide insights into the perspectives of clinical specialists (CSs) regarding the efficacy of existing legal interventions (health laws, policies, guidelines, etc) in addressing and managing perinatal depression (PND) in women in India, in the background of the existing policy gap.

Study design and methods: After adopting the consultative participatory approach, a qualitative study involving online, semi-structured, in-depth interviews was conducted. Purposive, and snowball sampling techniques were used to identify and invite the participants. Thematic content analysis was performed. The findings were reported in alignment with the Standards of Reporting Qualitative Research checklist.

Setting: India.

Participants: 12 out of 38 invited CSs participated in the study. All invited participants either had a background in perinatal psychiatry or were experienced in working with the perinatal population and had undertaken evidence-based research regarding perinatal mental health (PMH), in the Indian setting.

Results: Five themes emerged from the collected data including (1) the epidemiology of PND in the Indian context, (2) the management of PND in India and the efficacy of the existing legal frameworks, (3) the need for legal interventions for addressing and managing PND in India, (4) role of legislative instruments, globally, in managing maternal PND and (5) advocacy for PMH by lawyers, and advocates in India.

Conclusions: The existing policy gap is associated with the violation of women's rights. The Mental Health Care Act (MHCA), 2017 should be amended to recognise perinatal women as a vulnerable group and to prioritise their PMH needs. A nationwide policy should be introduced to ensure integrated PMH services.