Skip to main content

Advertisement

Log in

Racial/Ethnic Differences in the Correlates of Mental Health Services Use among Pregnant Women with Depressive Symptoms

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives To examine correlates of lifetime mental health services (MHS) use among pregnant women reporting prenatal depressive symptoms by race/ethnicity. Methods This cross-sectional population-based study included 81,910 pregnant women with prenatal depressive symptoms using data from the Florida Healthy Start prenatal screening program (2008–2012). Multivariable logistic regression was conducted to ascertain adjusted odds ratios and corresponding 95 % confidence intervals for racial/ethnic differences in the correlates of lifetime MHS use. Results Findings of this study revealed racial/ethnic differences in MHS use among women with prenatal depressive symptoms, the highest rates being among non-Hispanic Whites and the lowest rates among Mexicans and other Hispanics. Most need for care factors, including illness, tobacco use, and physical or emotional abuse, consistently predicted MHS use across racial/ethnic groups after adjusting for covariates. Adjusted associations between predisposing and enabling/restricting factors and MHS use were different for different racial/ethnic groups. Conclusions Racial/ethnic differences in MHS use were found, with pregnant Hispanic women reporting prenatal depressive symptoms being the least likely to use MHS. Our study findings have significant public health implications for targeted intervention for pregnant women with prenatal depressive symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Acri, M., Olin, S. S., Burton, G., Herman, R. J., & Hoagwood, K. E. (2014). Innovations in the identification and referral of mothers at risk for depression: Development of a peer-to-peer model. Journal of Child and Family Studies, 23(5), 837–843. doi:10.1007/s10826-013-9736-z.

    Article  PubMed  Google Scholar 

  2. Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C.-N., Takeuchi, D., & Meng, X.-L. (2008). Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services, 59(11), 1264–1272.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Alegria, M., Mulvaney-Day, N., Woo, M., Torres, M., Gao, S., & Oddo, V. (2007). Correlates of past-year mental health service use among Latinos: Results from the National Latino and Asian American Study. American Journal of Public Health, 97(1), 76–83. doi:10.2105/ajph.2006.087197.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(March), 1–10.

    Article  CAS  PubMed  Google Scholar 

  5. Anderson, C. M., Robins, C. S., Greeno, C. G., Cahalane, H., Copeland, V. C., & Andrews, R. M. (2006). Why lower income mothers do not engage with the formal mental health care system: Perceived barriers to care. Qualitative Health Research, 16(7), 926–943. doi:10.1177/1049732306289224.

    Article  PubMed  Google Scholar 

  6. Ani, C., Bazargan, M., Bazargan-Hejazi, S., Andersen, R. M., Hindman, D. W., & Baker, R. S. (2008). Correlates of self-diagnosis of chronic medical and mental health conditions in under-served African American and Latino populations. Ethnicity & Disease, 18(2 Suppl 2), S2-105-111.

  7. Avasarala, J. R., Cross, A. H., & Trinkaus, K. (2003). Comparative assessment of Yale Single Question and Beck Depression Inventory Scale in screening for depression in multiple sclerosis. Multiple Sclerosis, 9(3), 307–310. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12814181.

  8. Babitsch, B., Gohl, D., & Lengerke, T. V. (2012). Re-revisiting Andersen’s behavioral model of health services use: A systematic review of studies from 1998–2011. GMS Psycho-Social-Medicine, 9, 1860–5214.

    Google Scholar 

  9. Behague, D. P., Goncalves, H. D., Gigante, D., & Kirkwood, B. R. (2012). Taming troubled teens: The social production of mental morbidity amongst young mothers in Pelotas, Brazil. Social Science and Medicine, 74(3), 434–443. doi:10.1016/j.socscimed.2011.10.014.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Bledsoe, S. E. (2008). Barriers and promoters of mental health services utilization in a Latino context: A literature review and recommendations from an ecosystems perspective. Journal of Human Behavior in the Social Environment, 18(2), 151–183. doi:10.1080/10911350802285870.

    Article  Google Scholar 

  11. Cho, H., Kim, I., & Velez-Ortiz, D. (2014). Factors associated with mental health service use among Latino and Asian Americans. Community Mental Health Journal, 50(8), 906–907. doi:10.1007/s10597-014-9719-6.

    Article  Google Scholar 

  12. Cummings, J. R., & Druss, B. G. (2011). Racial/ethnic differences in mental health service use among adolescents with major depression. Journal of the American Academy of Child and Adolescent Psychiatry, 50(2), 160–170.

    Article  PubMed  Google Scholar 

  13. Davalos, D. B., Yadon, C. A., & Tregellas, H. C. (2012). Untreated prenatal maternal depression and the potential risks to offspring: A review. Arch Womens Ment Health, 15(1), 1–14. doi:10.1007/s00737-011-0251-1.

    Article  PubMed  Google Scholar 

  14. Farr, S. L., Bitsko, R. H., Hayes, D. K., & Dietz, P. M. (2010). Mental health and access to services among US women of reproductive age. American Journal of Obstetrics and Gynecology, 203(6), 542 e541–549. doi:10.1016/j.ajog.2010.07.007.

  15. Flick, L. H., Cook, C. A., Homan, S. M., McSweeney, M., Campbell, C., & Parnell, L. (2006). Persistent tobacco use during pregnancy and the likelihood of psychiatric disorders. American Journal of Public Health, 96(10), 1799–1807. doi:10.2105/AJPH.2004.057851.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gallagher, T. C., Andersen, R. M., Koegel, P., & Gelberg, L. (1997). Determinants of regular source of care among homeless adults in Los Angeles. Medical Care, 35(8), 814–830.

    Article  CAS  PubMed  Google Scholar 

  17. Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5), 1071–1083.

    Article  PubMed  Google Scholar 

  18. Goodwin, R., & Andersen, R. M. (2002). Use of the behavioral model of health care use to identify correlates of use of treatment for panic attacks in the community. Social Psychiatry and Psychiatric Epidemiology, 37(5), 212–219. doi:10.1007/s00127-002-0543-x.

    Article  PubMed  Google Scholar 

  19. Johnson, M., Mills, T. L., Deleon, J. M., Hartzema, A. G., & Haddad, J. (2009). Lives in isolation: Stories and struggles of low-income African American women with panic disorder. CNS Neuroscience & Therapeutics, 15(3), 210–219. doi:10.1111/j.1755-5949.2009.00079.x.

    Article  Google Scholar 

  20. Kilbourne, A. M., Andersen, R. M., Asch, S., Nakazono, T., Crystal, S., Stein, M., et al. (2002). Response to symptoms among a U.S. national probability sample of adults infected with human immunodeficiency virus. Medical Care Research and Review, 59(1), 36–58.

    Article  PubMed  Google Scholar 

  21. Ko, J. Y., Farr, S. L., Dietz, P. M., & Robbins, C. L. (2012). Depression and treatment among U.S. pregnant and nonpregnant women of reproductive age, 2005–2009. Journal of Women’s Health (Larchmt), 21(8), 830–836. doi:10.1089/jwh.2011.3466.

    Article  Google Scholar 

  22. Lee, A. M., Lam, S. K., Lau, S. M. S. M., Chong, C. S., Chui, H. W., & Fong, D. Y. (2007). Prevalence, course, and risk factors for antenatal anxiety and depression. Obstetrics and Gynecology, 110(5), 1102–1112. doi:10.1097/01.aog.0000287065.59491.70.

    Article  PubMed  Google Scholar 

  23. Mahmood, A. (2009). Attitudes towards help-seeking among South Asian American Muslim women. ProQuest LLC. UMI number: 3347233.

  24. Martinez Tyson, D., Arriola, N. B., & Corvin, J. (2015). Perceptions of depression and access to mental health care among Latino immigrants: Looking beyond one size fits all. Qualitative Health Research,. doi:10.1177/1049732315588499.

    PubMed  Google Scholar 

  25. National Institute for Health Care Management Foundation. (2010). Identifying and treating maternal depression: Strategies & considerations for health plans, NIHCM Foundation Issue Brief. Retrieved from http://nihcm.org/pdf/FINAL_MaternalDepression6-7.pdf.

  26. Raposa, E., Hammen, C., Brennan, P., & Najman, J. (2014). The long-term effects of maternal depression: Early childhood physical health as a pathway to offspring depression. Journal of Adolescent Health, 54(1), 88–93. doi:10.1016/j.jadohealth.2013.07.038.

    Article  PubMed  Google Scholar 

  27. Rhodes, A. E., & Fung, K. (2004). Self-reported use of mental health services versus administrative records: care to recall? International Journal of Methods in Psychiatric Research, 13(3), 165–175. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15297900.

  28. Rhodes, A. E., Lin, E., & Mustard, C. A. (2002). Self-reported use of mental health services versus administrative records: should we care? International Journal of Methods in Psychiatric Research, 11(3), 125–133. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12459825.

  29. Sentell, T., Shumway, M., & Snowden, L. (2007). Access to mental health treatment by English language proficiency and race/ethnicity. Journal of General Internal Medicine, 22(Suppl 2), 289–293. doi:10.1007/s11606-007-0345-7.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Shansky, R. M. (2009). Estrogen, stress and the brain: Progress toward unraveling gender discrepancies in major depressive disorder. Expert Review of Neurotherapeutics, 9(7), 967–973. doi:10.1586/ern.09.46.

    Article  CAS  PubMed  Google Scholar 

  31. Shim, R. S., Compton, M. T., Rust, G., Druss, B. G., & Kaslow, N. J. (2009). Race–ethnicity as a predictor of attitudes toward mental health treatment seeking. Psychiatric Services, 60, 1336–1341.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Song, D., Sands, R. G., & Wong, Y. L. (2004). Utilization of mental health services by low-income pregnant and postpartum women on medical assistance. Women and Health, 39(1), 1–24. doi:10.1300/J013v39n01_01.

    Article  PubMed  Google Scholar 

  33. Stewart, D. E. (2011). Depression during pregnancy. New England Journal of Medicine, 365, 1605–1611.

    Article  CAS  PubMed  Google Scholar 

  34. Szegda, K., Markenson, G., Bertone-Johnson, E. R., & Chasan-Taber, L. (2014). Depression during pregnancy: A risk factor for adverse neonatal outcomes? A critical review of the literature. The Journal of Maternal-Fetal & Neonatal Medicine, 27(9), 960–967. doi:10.3109/14767058.2013.845157.

    Article  Google Scholar 

  35. Ta, V. M., Juon, H.-S., Gielen, A. C., Steinwachs, D., & Duggan, A. (2008). Disparities in use of mental health and substance abuse services by Asian and Native Hawaiian/other Pacific Islander women. The Journal of Behavioral Health Services & Research, 35(1), 20–36.

    Article  Google Scholar 

  36. U.S. Census Bureau. (2009). The 2012 statistical abstract: Table 690. Money income of households—Percent distribution by income level, race, and Hispanic origin, in constant Dollars: 1990 to 2009. Retrieved from https://www.census.gov/compendia/statab/2012/tables/12s0690.pdf.

  37. U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity—A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human SErvices, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

  38. U.S. Department of Health and Human Services. (2009). Services ASPE fact sheet: Vulnerable youth and the transition to adulthood-Youth from low-income families. Retrieved from http://aspe.hhs.gov/hsp/09/VulnerableYouth/3/index.shtml.

  39. Watkins, C. L., Lightbody, C. E., Sutton, C. J., Holcroft, L., Jack, C. I., Dickinson, H. A., et al. (2007). Evaluation of a single-item screening tool for depression after stroke: A cohort study. Clinical Rehabilitation, 21(9), 846–852. doi:10.1177/0269215507079846.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors acknowledge and appreciate the Florida Department of Health as the original source of the data. The analysis, interpretations, and conclusions in the present study are those of the authors and not the Florida Department of Health.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jen Jen Chang.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chang, J.J., Tabet, M., Elder, K. et al. Racial/Ethnic Differences in the Correlates of Mental Health Services Use among Pregnant Women with Depressive Symptoms. Matern Child Health J 20, 1911–1922 (2016). https://doi.org/10.1007/s10995-016-2005-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-016-2005-1

Keywords

Navigation