Barriers to mental health treatment among obstetric patients at risk for depression

Objective The objective of the study was to examine mental health referrals outcomes among obstetric patients at risk for depression. Study Design Fifty-one perinatal women who were offered mental health referrals were queried about their behaviors at 4 steps in the treatment engagement process and...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2010-03, Vol.202 (3), p.312.e1-312.e5
Main Authors: Kim, J. Jo, PhD, La Porte, Laura M., MA, LCSW, Corcoran, Mariah, MA, LSW, Magasi, Susan, PhD, OTR, Batza, Jennifer, MA, LSW, Silver, Richard K., MD
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Biological and medical sciences
Delivery. Postpartum. Lactation
Depression
Depression - epidemiology
Depression - therapy
Female
Gynecology. Andrology. Obstetrics
Hotlines
Humans
Medical sciences
mental health
Mental Health Services - utilization
Mood disorders
Obstetrics and Gynecology
Patient Acceptance of Health Care - statistics & numerical data
Patient Participation
perinatal depression
Pregnancy
Pregnancy Complications - psychology
Pregnancy Complications - therapy
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Referral and Consultation
Risk
treatment engagement
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Summary:Objective The objective of the study was to examine mental health referrals outcomes among obstetric patients at risk for depression. Study Design Fifty-one perinatal women who were offered mental health referrals were queried about their behaviors at 4 steps in the treatment engagement process and factors facilitating or impeding each step. Results Although 59% of at-risk women accepted mental health referrals, only 27% ultimately engaged in treatment. Women who proactively sought help via a hotline were more likely to accept referrals ( P < .001), contact a referred provider ( P < .001), and engage in treatment ( P < .05) than those who received unsolicited referrals after screening at-risk for depression. Barriers to successful treatment linkage were identified at the patient, provider, and system levels. Conclusion Only a minority of women who are at risk for perinatal depression and receive mental health referrals ultimately engage in treatment. Successful linkage may be enhanced via interventions targeting identified barriers; such interventions require prospective evaluation.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2010.01.004