What helps and what hinders? Perspectives of perinatal women and healthcare providers on perinatal mental health screening in a metropolitan city in Southern India

Common perinatal mental disorders, including depression, anxiety, and stress-related conditions, significantly impact maternal and child health. Despite their high prevalence, CPMDs often go undetected and untreated, particularly in low- and middle-income countries. Integrating mental health screening into routine maternal care is crucial for early identification and intervention. However, implementation faces multiple challenges. This study aims to explore the facilitators and barriers to screening perinatal women for CMDs in healthcare facilities in Bengaluru, India, from the perspectives of healthcare providers and perinatal women. A qualitative study was conducted between October 2024 and March 2025 among 20 participants, including 10 healthcare providers and 10 perinatal women from public and private healthcare facilities in a zonal administrative unit of an Indian city, Bengaluru. Key informant interviews (KIIs) were conducted, and the data were analyzed to identify key system-level and individual-level facilitators and barriers. Facilitators included a well-established referral system, drug availability, provider willingness to screen, privacy in consultations, and the integration of screening questions into the Thayi (Mother and Child Protection) Card. We identified several barriers, including fragmentation between maternal and mental health services, high provider workload, lack of dedicated mental health professionals, and inadequate training on mental health screening. Perinatal women faced stigma, limited awareness of mental health, reluctance to seek help, and misconceptions about treatment. The presence of family members during consultations further hindered open discussions. These findings highlight the need for context-specific, integrated strategies, including workforce strengthening and stigma reduction, to improve perinatal mental health screening and care.