Each Is in Different Circumstances Anyway: A Realist Multilevel Situational Analysis of Maternal Depression in South Western Sydney, Australia

摘要

We present here a realist multilevel situational analysis of maternal depression. We use situational analysis to identify the interaction of mothers with social structures and the possible causal influence of those social structures on her well-being. The analysis moves from an emergent empirical approach toward the more reflexive and abductive approach of situational analysis, thus better informing our abductive reasoning and the generation of theory. Critical realism and symbolic interactionism provide the methodological underpinning for the study. The setting was South Western Sydney, Australia. Interviews of mothers and practitioners were analyzed using open coding to enable maximum emergence. Situational analysis was then undertaken using situational and social worlds/arena maps. Home and neighborhood situational analysis mapping and analysis of relations identified the following concepts: (a) expectations and dreams, (b) marginalization and being alone, (c) loss or absence of power and control, and (d) support and nurturing. The neighborhood and macro-arena situational analysis mapping and analysis of relations identified the following concepts: (a) social support networks, social cohesion and social capital; (b) services planning and delivery and social policy; and (c) global economy, business, and media. Emerging was the centrality of being alone and expectations lost as possible triggers of stress and depression within circumstances where media portrays expectations of motherhood that are shattered by reality and social marginalization. We further observe that powerful global economic and political forces are having an impact on the local situations. The challenge for policy and practice is to support families within this adverse regional and global economic context.