Clinical and Health Services Research, Division of Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Suite 800, Bethesda, MD, 20892, USA.
Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Suite 800, Bethesda, MD, 20892, USA.
Arch Womens Ment Health. 2021 Oct;24(5):781-791. doi: 10.1007/s00737-021-01132-5. Epub 2021 Apr 15.
Limited research has examined factors that impact access to postpartum mental healthcare. We investigated the predisposing, enabling, and need factors associated with postpartum consultation for mental health concerns in US mothers with or without depressive symptoms and examined potential disparities in access. We utilized cross-sectional data from the Listening to Mothers II Survey, the second national US survey of women's childbearing experiences. The survey recruited 1573 women, aged 18-45 years, who spoke English and had given birth. Depressive symptoms were measured with the Postpartum Depression Screening Scale (PDSS-SF). The dependent variable was postpartum consultation for mental health concerns. Logistic regression analyses showed that mothers with scores of 14-21 and 22-35 on the PDSS-SF had higher odds of consulting a provider for mental health concerns (OR 3.97; OR 12.91). Latinas had lower odds of seeking mental health consultations than Whites (OR 0.39). Mothers who were employed prenatally full-time or part-time had lower odds of seeking consultations than non-employed mothers (OR 0.62; OR 0.52). Mothers with household incomes of $50,000-$74,999 had higher odds of seeking consultations than those with incomes less than $25,000 (OR 2.20). When regression analyses were restricted to mothers with PDSS-SF scores ≥ 14, findings were similar by race/ethnicity and prenatal employment. Significant depressive symptoms are common in women after giving birth and few sought any form of mental health consultation. Latinas and low-income women are less likely to seek postpartum mental health consultations. Mental health care interventions could be geared towards targeting these at-risk groups.
有限的研究考察了影响产后心理健康保健获取的因素。我们调查了与有或没有抑郁症状的美国母亲产后寻求心理健康咨询相关的倾向因素、促成因素和需求因素，并探讨了获取途径的潜在差异。我们利用了来自“倾听母亲 II 调查”（Listening to Mothers II Survey）的横断面数据，这是美国第二次全国性的女性生育经历调查。该调查招募了 1573 名年龄在 18-45 岁之间、会讲英语且已生育的女性。抑郁症状用产后抑郁筛查量表（Postpartum Depression Screening Scale，PDSS-SF）进行测量。因变量是产后寻求心理健康咨询的情况。逻辑回归分析显示，PDSS-SF 评分为 14-21 分和 22-35 分的母亲更有可能向提供者咨询心理健康问题（OR 3.97；OR 12.91）。拉丁裔母亲寻求心理健康咨询的可能性低于白人（OR 0.39）。与未就业母亲相比，产前全职或兼职就业的母亲寻求咨询的可能性较低（OR 0.62；OR 0.52）。家庭收入在 50000-74999 美元之间的母亲寻求咨询的可能性高于收入低于 25000 美元的母亲（OR 2.20）。当回归分析仅限于 PDSS-SF 评分≥14 的母亲时，种族/族裔和产前就业方面的发现相似。产后妇女出现明显抑郁症状的情况很常见，但很少有人寻求任何形式的心理健康咨询。拉丁裔和低收入妇女寻求产后心理健康咨询的可能性较低。心理健康护理干预措施可以针对这些高风险群体。
