Pathways into perinatal mental health care: the role of service context, stigma, and discrimination Ref: 5888

Supervisors

Professor Heather O’Mahen - University of Exeter - Faculty of Health and Life Sciences

Dr Henrietta Roberts - University of Exeter - Faculty of Health and Life Sciences

Dr Abigail Easter – King’s College London - https://www.kcl.ac.uk/people/abigail-easter

NIHR Applied Research Collaboration (ARC) South West is inviting applications for a PhD studentship to commence on 21 September 2026 or as soon as possible thereafter.  For eligible students the studentship will cover Home tuition fees plus an annual tax-free stipend of at least £21,805 for 3 years full-time. We welcome applicants who wish to study less than full-time, provided they complete their studies before March 2031. The student would be based in the ARC South West in the Faculty of Health and Life Sciences at St Luke’s Campus in Exeter. A training and development budget will also be provided to support the activity of the student.

 Perinatal mental health difficulties are common and represent a major public health concern, with significant consequences for women, infants, and families. In the UK, perinatal mental health disorders affect approximately one in four women and are a leading cause of maternal morbidity, and are associated with longer-term risks for children's emotional, social, and developmental outcomes. Improving access to timely and effective support during the perinatal period is therefore a priority for both women’s mental health and child and family wellbeing.

Recent national policy emphasises prevention, digitalisation, and a shift from hospital-centered to community-based provision (e.g., NHS Mental Health 10 Year Plan, Fit for the Future plan, National Family Hub expansion). Family Hubs and voluntary care sector enterprise (VCSE) partnerships are explicitly promoted as accessible, de-stigmatising “one-stop” settings for early support, including for perinatal parents with “mild to moderate” mental health problems. However, despite increased provision and screening, access remains low: only an estimated 8–30% of women with perinatal mental health difficulties receive care during this period (compared with 50% for women’s mental health outside the perinatal period). Patterns of engagement vary by socioeconomic position, ethnicity and social complexity, with those with more complex situations at greatest risk of only receiving treatment at the most acute end of care.

Research suggests that variations in access to care are driven by a combination of factors, including structural and support barriers that, critically, interact with psychological factors such as stigma and fear of discrimination. Understanding how these processes operate and what forms of support make a difference at the early stages of mental health treatment is critical to ensuring equitable access to early, effective care (i.e., Family Hubs/community provision, NHS Talking Therapies, VCSE). 

2. Problem or issue to be investigated. 

Policy assumes community-based models are less stigmatising and more accessible than specialist NHS services, yet empirical evidence is limited and largely drawn from people who have already been engaged with services. Little comparative work examines how women navigate between services, which groups attend which settings, what support they actually receive, or whether community settings are de-stigmatising for whom. This is particularly problematic given that women from ethnically minoritised groups, lower socioeconomic backgrounds, or complex social circumstances are more likely to be found in community/VCSE settings, where provision can be lighter-touch and may be less consistently evidence-based. Without cross-service evidence about stigma, identity processes, and pathways into care, investments in community provision risk failing to reach those most in need or unintentionally reinforcing inequities.

There is a need for applied research that compares service contexts, captures the views of women who do not engage with formal care, and identifies psychological mechanisms that could be targeted to improve early disclosure, uptake, retention and equity of perinatal mental health support.

 3. Research questions/aims and objectives. 

1. How do women experiencing perinatal mental health difficulties perceive and navigate different forms of support across services? 2. How are identity, stigma and fears of discrimination experienced across service contexts, and how do these experiences vary by setting? 3. How do these psychological processes influence disclosure, engagement and retention in perinatal mental health care? 4. How do pathways into care and experiences of support differ according to ethnicity, socioeconomic position and social complexity?

4. Proposed methodology and methods. 

A mixed-method PhD integrating state-of-the art theory and evidence from psychology about factors driving stigma, discrimination and identity with applied, public-health and PPIE driven solutions. Approaches should include both qualitative and quantitative methods, including experimental design.

“The studentship will be awarded on the basis of academic merit. Students who pay international tuition fees are eligible to apply. However, these candidates should note the following:

• The award covers only part of the international tuition fee, approximately £27,000.
• It does not include a stipend for living expenses.
• International applicants will need to cover additional costs, including:
• Student visa fees
• Immigration Health Surcharge
• Relocation expenses associated with moving to the UK to undertake a PhD.

International fee-paying applicants should ensure they have sufficient funds to meet these costs before applying.

The conditions for eligibility of home fees status are complex and you will need to seek advice if you have moved to or from the UK (or Republic of Ireland) within the past 3 years or have applied for settled status under the EU Settlement Scheme.”

Entry requirements

Applicants for this studentship must have obtained, or be about to obtain, a First or Upper Second Class UK Honours degree, or the equivalent qualifications gained outside the UK, in an appropriate area of health or healthcare research.

 If English is not your first language you will need to meet the English language requirements and provide proof of proficiency. Click here for more information.

 Doctoral Award Person Specification

Essential

·         Hold a 1st or 2:1 bachelor’s degree, or equivalent. If not, you will usually need to have a relevant master’s degree

·         Have prior research experience or training to prepare for a PhD

·         Not already hold a relevant PhD or equivalent

·         Show strong academic and professional skills needed to complete a PhD

Desirable

·         Demonstrate originality and independent critical thinking in proposing research with real-world benefits for patients, the public, and the health and social care system

·         Knowledge of the priorities in the area of research interest

·         Demonstrate an alignment with NIHR strategic priorities, where applicable.

Successful applicants will become members of the NIHR Academy, and further information about this can be found here https://www.nihr.ac.uk/career-development/research-career-funding-programmes/supporting-career-development/opportunities-infrastructure. 

How to apply

Apply now

To apply, please click the ‘Apply Now’ button above. In the application process you will be asked to upload several documents: 

•             CV

•             Letter of application (outlining your academic interests, prior research experience and reasons for wishing to undertake the project).

•             Transcript(s) giving full details of subjects studied and grades/marks obtained (this should be an interim transcript if you are still studying)

•             Two references from referees familiar with your academic work. If your referees prefer, they can email the reference direct to PGRApplicants@exeter.ac.uk quoting the studentship reference number.

•             If you are not a national of a majority English-speaking country you will need to submit evidence of your proficiency in English.

The closing date for applications is midnight on 28th July 2026.  Interviews will be held virtually in August 2026.

All application documents must be submitted in English. Certified translated copies of academic qualifications must also be provided.

Please quote reference 5888 on your application and in any correspondence about this studentship.

NIHR are committed to equality, diversity and inclusion in everything we do. Diverse people and communities shape our research, and we strive to make opportunities to participate in research an integral part of everyone’s experience of health and social care services. We develop researchers from multiple disciplines, specialisms, geographies and backgrounds, and work to address barriers to career progression arising from characteristics such as sex, race or disability. Please let us know if you need any reasonable adjustments made to the application process and we will be happy to explore whether this is possible. 

Potential applicants working in community, social care and public health are welcome to contact us to explore their suitability. For general information about this studentship and the application process, please contact PGRApplicants@exeter.ac.uk.  Project specific queries should be directed to the lead supervisor H.OMahen@exeter.ac.uk. 

Summary