Term of Award

Spring 2021

Degree Name

Doctor of Public Health in Community Health Behavior and Education (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


College of Public Health

Committee Chair

Joseph Telfair

Committee Member 1

Joanne Chopak-Foss

Committee Member 2

Bettye Apenteng

Non-Voting Committee Member

Charles Michelo


Perinatal mental illness (PMI) is a significant public health concern. If not attended to, PMI can be detrimental to the wellbeing of women and their families. Globally, about 10% of pregnant women and 13% of women who have just given birth experience a mental illness, primarily depression (WHO, 2020). According to the Centers for Disease Control and Prevention (CDC), in Georgia, the self-reported rate of perinatal mental illnesses stands at 16.6%, higher than the US average. Research suggests that women in rural areas are at a higher risk of perinatal depression and anxiety than their urban counterparts. Some states in the United States face a shortage of mental healthcare providers, impacting mental health service delivery. This qualitative study uses the Andersen healthcare utilization model to explore factors affecting the use and provision of perinatal mental health services from women and providers’ perspectives in Bulloch County, GA.

One-on-one in-depth interviews were conducted with 24 women who had been diagnosed with a perinatal mental illness. They were recruited through snowball sampling. In addition, 15 mental health providers in Bulloch county, recruited through professional networks completed open ended surveys. Qualitative thematic analysis was used to summarize and interpret the data.

Major themes amongst women included: Delayed symptom awareness, limited access to service availability, individual and cultural beliefs, lack of resource awareness, family and friend support, history of mental health, and severity of illness. Barriers among providers included lack of available resources and lack of rapport among patients and providers. Facilitators included increase in mental health screening, rapport building, education and awareness. Findings from this study will be useful in developing tailored interventions to address barriers to perinatal mental healthcare utilization experienced by both women and perinatal mental health care providers.

OCLC Number


Research Data and Supplementary Material