Enhancing support for postpartum psychosis through a socio-ecological lens: A qualitative analysis

Postpartum psychosis (PP) is a severe mental health condition that affects approximately 1–2 per 1,000 births. Symptoms often begin within the first two weeks after childbirth and can include hallucinations, delusions, mood changes, and confusion. PP is considered a psychiatric emergency and requires prompt treatment to protect the health and safety of both parent and baby. 

Although effective treatments for PP exist, many individuals experience barriers to receiving timely care and ongoing support during recovery. Previous research has identified contributing factors such as stigma, difficulty accessing specialized care, and limited awareness of PP among healthcare providers and the public. However, less is known about what individuals with lived experience of PP believe would best facilitate recovery. 

To better understand recovery from PP, this study analyzed responses from 131 individuals enrolled in the Massachusetts General Hospital Postpartum Psychosis Project (MGHP3). Participants completed an online follow-up survey and answered the open-ended question, "How do you think those who experience postpartum psychosis can be best supported?" Researchers used qualitative content analysis to identify common themes and organized these findings using the Socio-Ecological Model (SEM), a public health framework that examines how individual, interpersonal, community, healthcare, policy, and societal factors influence health and well-being.

Participants had previously completed a structured clinical interview confirming a diagnosis of PP and later completed the follow-up survey remotely. Individuals who completed the survey received a $25 Amazon gift card. Additional details about the study methods and qualitative analysis can be found in the full paper. 

Researchers identified several themes describing how support for PP recovery can be improved across multiple levels the SEM. 

Key findings: 

• At the individual level, participants emphasized the importance of self-acceptance and self-compassion Many shared that knowing recovery is possible helped foster hope. 

• At the interpersonal level, participants highlighted the importance of support from family, friends, healthcare providers, and assistance with childcare, sleep, and other daily responsibilities during recovery. 

• At the community level, participants described the value of peer support groups, community resources, and services for family members who are also affected by PP. 

• At the organizational level, participants recommended improving healthcare provider education about PP, increasing access to specialized care, enhancing communication with patients and families, and expanding mother-baby treatment options when appropriate. 

• At the policy level, participants advocated for paid family leave, improved insurance coverage for postpartum mental health care, and broader access to therapy and postpartum support services. 

• At the societal level, participants emphasized the need to reduce stigma surrounding PP and increase public awareness to encourage earlier recognition and treatment. 

  
  

What does this mean? 

• Recovery from PP involves much more than medical treatment alone. Individuals with lived experience described recovery as being influenced by support from family, healthcare providers, communities, and workplaces.  

• These findings suggest that improving recovery from PP will likely require coordinated efforts across multiple levels of the SEM, including better provider education, stronger support networks, expanded access to mental healthcare, policies that support new parents, and increased public awareness to reduce stigma. 

• The Socio-Ecological Model provides a useful framework for understanding these different influences and may help guide future interventions designed to im

  prove recovery for individuals experiencing PP. 

  
  

A strength of this study is its large, geographically diverse sample of individuals with confirmed PP diagnoses. However, the study also has several limitations. Most participants were white, highly educated, and privately insured, which may limit generalizability.  

Future research should continue incorporating the perspectives of individuals with lived experience while developing and evaluating interventions that address recovery at multiple levels, from individual care to broader healthcare systems and public policy. 

Citation:  Scalise AL, Yoon HE, Barest PE, et al. Enhancing support for postpartum psychosis through a socio-ecological lens: A qualitative analysis. Journal of Health Psychology. 2026;0(0). doi:10.1177/13591053261460698 

Written by: Celina Lim, Clinical Research Coordinator