Impact of the COVID-19 pandemic on mental health, access to care, and health disparities in the perinatal period

The COVID-19 pandemic has affected mental health and created barriers to healthcare. In this study, we sought to elucidate the pandemic's effects on mental health and access to care for perinatal individuals. This cross-sectional study of individuals in Massachusetts who were pregnant or up to...

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Bibliographic Details
Published in:	Journal of psychiatric research 2021-05, Vol.137, p.126-130
Main Authors:	Masters, Grace A., Asipenko, Eugenia, Bergman, Aaron L., Person, Sharina D., Brenckle, Linda, Moore Simas, Tiffany A., Ko, Jean Y., Robbins, Cheryl L., Byatt, Nancy
Format:	Article
Language:	eng
Subjects:	Access to care Adult Analysis Anxiety Anxiety - epidemiology Anxiety - therapy COVID-19 - epidemiology COVID-19 pandemic Cross-Sectional Studies Depression Depression - epidemiology Depression - therapy Depression, Mental Epidemics Female Health aspects Health care reform Health Services Accessibility - statistics & numerical data Healthcare Disparities - statistics & numerical data Humans Massachusetts - epidemiology Medical screening Mental health Mental Health - statistics & numerical data Pandemics Perinatal Care - statistics & numerical data Perinatal mental health Post-traumatic stress disorder Pregnancy Public health Short Communication
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Summary:	The COVID-19 pandemic has affected mental health and created barriers to healthcare. In this study, we sought to elucidate the pandemic's effects on mental health and access to care for perinatal individuals. This cross-sectional study of individuals in Massachusetts who were pregnant or up to three months postpartum with a history of depressive symptoms examined associations between demographics and psychiatric symptoms (via validated mental health screening instruments) and the COVID-19 pandemic's effects on mental health and access to care. Chi-square associations and multivariate regression models were used. Of 163 participants, 80.8% perceived increased symptoms of depression and 88.8% of anxiety due to the pandemic. Positive screens for depression, anxiety, and/or PTSD at time of interview, higher education, and income were associated with increased symptoms of depression and anxiety due to the pandemic. Positive screens for depression, anxiety, and/or PTSD were also associated with perceived changes in access to mental healthcare. Compared to non-Hispanic White participants, participants of color (Black, Asian, Multiracial, and/or Hispanic/Latinx) were more likely to report that the pandemic changed their mental healthcare access (aOR:3.25, 95%CI:1.23, 8.59). Limitations included study generalizability, given that participants have a history of depressive symptoms, and cross-sectional design. The pandemic has increased symptoms of perinatal depression and anxiety and impacted perceived access to care. Self-reported increases in depression and anxiety and changes to healthcare access varied by education, race/ethnicity, income, and positive screens. Understanding these differences is important to address perinatal mental health and provide equitable care. •The COVID-19 pandemic has affected mental health and access to care•In perinatal individuals with a depression history, 80.8% had increased depression and 88.8% anxiety due to the pandemic.•Changes in depression, anxiety, and access to care due to the pandemic varied by patient characteristics.•Patients of color (vs non-Latinx White) were 3-times as likely to have pandemic-related access to mental healthcare changes.
ISSN:	0022-3956 1879-1379