***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Postnatal depression affects 10–15 % of all mothers in Western societies and remains a major public health concern for women from diverse cultures . British Pakistani and Indian women have a higher prevalence of depression in comparison to their white counterparts . Research has shown that culturally adapted interventions using Cognitive Behavioural Therapy ( CBT ) may be acceptable and may help to address the needs of this population . The aim of this study was to assess the acceptability and overall experience of the Positive Health Programme by British South Asian mothers . Methods This was a nested qualitative study , part of an exploratory r and omized controlled trial ( RCT ) conducted to test the feasibility and acceptability of a culturally-adapted intervention ( Positive Health Programme or PHP ) for postnatal depression in British South Asian women .  In-depth interviews ( N = 17 ) were conducted to determine the views of the participants on the feasibility and acceptability of the intervention . Results The participants found the intervention acceptable and experienced an overall positive change in their attitudes , behaviour , and increased self-confidence . Conclusions The findings suggest that the culturally adapted Positive Health Programme is acceptable to British South Asian women . These results support that culturally sensitive interventions may lead to better health outcomes and overall satisfaction . Trial registration Protocol registered on Clinical trials.gov Background In the UK , 8–15 % of women suffer from postnatal depression with long term consequences for maternal mood and child development . Current guidelines state that health visitors and GPs should continue to have a major role in the detection and management of postnatal depression . Previous literature suggests that women are reluctant to disclose symptoms of postnatal depression . This study aim ed to explore general practitioners ' ( GPs ) , health visitors ' and women 's views on the disclosure of symptoms which may indicate postnatal depression in primary care . Methods In-depth interviews with GPs , health visitors and women who were participating in a r and omised controlled trial of anti-depressants versus health visitor delivered non-directive counselling for the treatment of postnatal depression . Interviews were audio-taped and fully transcribed . Thematic analysis with an iterative approach was used , allowing the views of practitioners and patients to be explored and then compared . Results Nineteen GPs , 14 health visitors and 28 women were interviewed . A number of common themes were identified across all three data sets : underst and ing and negotiating the diagnosis of postnatal depression , hindering and facilitating disclosure , and the system of care . Both women and health professionals described postnatal depression in psychosocial terms : an adjustment reaction to change in life circumstances and the reality of motherhood not meeting personal expectations . Women described making a conscious decision about whether or not to disclose their feelings to their GP or health visitor . Health professionals described strategies used to hinder disclosure and described a reluctance to make a diagnosis of postnatal depression , as they had few personal re sources to manage women with postnatal depression themselves , and no services to which to refer women for further treatment . Conclusion To improve disclosure of symptoms in primary care , there should be a move away from question ing why health professionals do not make the diagnosis of depression and in response suggesting that education and training will improve skills and thus improve detection of depression . Improving the detection and management of postnatal depression in primary care requires recognition of the context in which women consult , and system changes that ensure health professionals work in an environment that can facilitate disclosure and that the necessary re sources for management are available . Trail Registration IS RCT N BACKGROUND In the UK , 8 - 15 % of women suffer from postnatal depression , with long-term consequences for maternal mood and child development . Previous literature suggests that health visitors struggle with their conflicting roles with respect to mother and infant . Current policy is redirecting the emphasis and organisation of health visitor work , but guidelines state that health visitors and GPs should continue to have a major role in the detection and management of postnatal depression . AIM To explore the views of GPs and health visitors on the diagnosis and management of postnatal depression . DESIGN OF STUDY A qualitative study nested within a multicentre r and omised controlled trial . SETTING Nine primary care trusts in Bristol , Manchester , and London . METHOD In-depth interviews with GPs and health visitors from primary care trusts participating in a r and omised controlled trial of antidepressants versus health visitor-delivered non-directive counselling .  Interviews were audiotaped and fully transcribed . Thematic analysis with an iterative approach was used to develop conceptual categories from the transcripts . RESULTS Nineteen GPs and 14 health visitors were interviewed . GPs and health visitors described their work in making and negotiating the diagnosis of postnatal depression , the value of a long-term relationship with the woman , and how labelling affects management of women with postnatal depression . Responders described how they viewed others ' roles in the management of postnatal depression , and how national policy and local organisational changes had an impact on patient care , so that no one health professional was assuming overall responsibility for the care of women with postnatal depression . CONCLUSION Ongoing organisational changes within primary care , such as the implementation of corporate working by health visitors , affect care provided to women after birth , which in turn has an impact on the diagnosis and management of postnatal depression BACKGROUND Postnatal depression is a public health problem requiring intervention . To provide effective care , information is needed on the experiences of those with high levels of depressive symptoms who are offered and accept , or decline , psychological intervention postnatally . AIM To provide the first integrated in-depth exploration of postnatal women 's experiences of the identification and management of symptoms of depression and the offer and acceptance of postnatal care by health visitors taking part in the PoNDER trial . SETTING General practice : primary care within the former Trent regional health authority , Engl and . METHOD Thirty women with 6-week Edinburgh Postnatal Depression Scale ( EPDS ) scores ≥ 18 and probable depression completed semi-structured interviews . All women had taken part in the Post-Natal Depression Economic Evaluation and R and omised controlled ( PoNDER ) trial where  intervention group health visitors received training in identification of depressive symptoms and provided psychologically informed sessions based on cognitive-behavioural therapy or person-centred counselling principles . RESULTS When accepted , psychological sessions were experienced as positive , effective , and ' ideal care ' . Women approved of using the EPDS but did not underst and the health visitor 's role in supporting women . Seeking help and accepting sessions depended on women 's perspectives of their health visitor as an individual . CONCLUSION Women 's experience of their health visitors providing psychological sessions to help with postnatal depressive symptoms is highly positive . Women will better accept support from health visitors if they recognise their role in postnatal depression and find them easy to relate to on personal matters . There is a case for specific enhancement of interpersonal skills in health visiting , or alternatively offering a choice of health visitors to women 
    Output:
    
Conclusions Complex , interlinking , multilevel barriers to accessing mental health services for women with perinatal mental illness exist .