Perinatal mental health service use in a representative sample of US women

Abstract

Problem/Background

Mental health problems are prevalent during the perinatal period and mental health service use is lower among perinatal women compared to the general population.

Aim

This study examined the prevalence and variables associated with mental health service use (MHSU) among pregnant and postpartum women with a past-year mental disorder.

Methods

We analyzed nationally representative data from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309). Our study sample included all women aged 18 – 55 with a past year mental disorder (n = 6,295). Semi-structured interviews assessed past-year DSM-5 mental disorders, which were categorized into four groups: depressive/bipolar, anxiety, posttraumatic stress disorder, and substance use. Logistic regressions examined rates and variables associated with MHSU across perinatal status, adjusting for key sociodemographic characteristics.

Findings

Compared to non-perinatal women 18–55 with a past-year mental disorder (38.5 %), postpartum women had reduced odds of MHSU (23.6 %; AOR = 0.56, p < 0.05), and pregnant women also sought services less than non-perinatal women (32.6 %; AOR = 0.89 p > 0.05). All groups had increased odds of MHSU when individuals had a greater number of mental disorders (AORs = 1.78 – 2.75, p = 0.01 and p < 0.001). Physical health conditions were also associated with increased odds of MHSU among all groups, except postpartum women (AORs = 1.26 – 1.62, p = 0.05, p < 0.001).

Discussion/Conclusion

Results highlight that over 60 % of perinatal women with mental disorders do not receive mental health services. This emphasizes the importance of mental health screening for perinatal women, particularly in the postpartum period.