“I just held it to myself”: screening and treatment experiences of individuals with perinatal suicidal thoughts and behaviors

BACKGROUND: Suicide is a leading cause of maternal mortality, yet there are currently no evidence-based perinatal suicide prevention programs. Given the risk of serious outcomes if undetected or inadequately treated, the goal of this study was to further understand the screening and treatment experiences of individuals with perinatal suicidal thoughts and behaviors (STBs). METHODS: Qualitative data were generated from in-depth interviews with 13 individuals primarily from the United States who experienced perinatal suicidality at least 6 months prior to participation. Thematic analysis was used to examine the experiences of participants with respect to screening and treatment of perinatal STBs. RESULTS: Regarding screening, three major themes were identified: (1) gaps in comprehensive/routine screening for STBs (e.g., infrequent screenings or non-specific to suicide), (2) attitudes toward disclosure of STBs (resulting in omission of symptoms or downplaying of severity), and (3) importance of follow-up after screening. Three themes influenced participants' treatment experiences: (1) providers' engagement in care, (2) shared decision-making between provider and patient, and (3) impact of perinatal-specific treatment programs. CONCLUSION: Findings from this study highlight critical gaps in screening for and treatment of perinatal STBs. Implementing routine screening and comprehensive follow-up and improving treatment experiences are essential for improving the care of individuals with perinatal STBs and reducing maternal mortality.