Depressive Symptoms and Access to Mental Health Care in Women Screened for Postpartum Depression Who Lose Health Insurance Coverage After Delivery: Findings From the Translating Research Into Practice for Postpartum Depression (TRIPPD) Effectiveness Study

Abstract Objective To determine the impact of losing health insurance coverage on perceived need for and access to mental health care in women screened for postpartum depression (PPD) in primary care settings. Patients and Methods The study sample included 2343 women enrolled in a 12-month, multisit...

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Bibliographic Details
Published in:Mayo Clinic proceedings 2014-09, Vol.89 (9), p.1220-1228
Main Authors: Bobo, William V., MD, MPH, Wollan, Peter, PhD, Lewis, Greg, MD, Bertram, Susan, RN, MSN, Kurland, Margary J., RN, Vore, Kimberle, MD, Yawn, Barbara P., MD, MSc
Format: Article
Language:English
Subjects:
Adult
Care and treatment
Demographic aspects
Depression, Postpartum - diagnosis
Depression, Postpartum - epidemiology
Depression, Postpartum - psychology
Depression, Postpartum - therapy
Female
Health Services Accessibility - statistics & numerical data
Health Services Needs and Demand - statistics & numerical data
Humans
Insurance Coverage - statistics & numerical data
Insurance, Health - statistics & numerical data
Internal Medicine
Medical screening
Medically Uninsured - statistics & numerical data
Patient outcomes
Postpartum depression
Pregnancy
Psychiatric services
Risk factors
Services
Socioeconomic Factors
Surveys and Questionnaires
Treatment Outcome
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Summary:Abstract Objective To determine the impact of losing health insurance coverage on perceived need for and access to mental health care in women screened for postpartum depression (PPD) in primary care settings. Patients and Methods The study sample included 2343 women enrolled in a 12-month, multisite, randomized trial that compared clinical outcomes of a comprehensive PPD screening and management program with usual care (March 1, 2006, through August 31, 2010). Screening for PPD occurred at the first postpartum visit (5-12 weeks) using the Edinburgh Postnatal Depression Scale followed by the 9-item Patient Health Questionnaire. Insurance status during the prenatal period, at delivery, and during the first postpartum year and perceived need for and access to mental health care during the first postpartum year were assessed via questionnaires completed by individual patients and participating practices. Results Rates of uninsured increased from 3.8% during pregnancy and delivery (n=87 of 2317) to 10.8% at the first postpartum visit (n=253 of 2343) and 13.7% at any subsequent visit to the practice after 2 months post partum (n=226 of 1646) ( P
ISSN:0025-6196
1942-5546
DOI:10.1016/j.mayocp.2014.05.011