Factors influencing receipt of mental health services for Black women living in Los Angeles County during the perinatal period

TL;DR

This study explores why many Black women in Los Angeles County don't get mental health care during pregnancy and childbirth, despite being at risk for mood and anxiety disorders.

Contribution

The study identifies factors influencing mental health service receipt among Black women during the perinatal period in Los Angeles County.

Findings

Most Black women received depression assessments during pregnancy or after childbirth, often conducted by nurses.

Education about postpartum depression significantly increased the likelihood of receiving mental health treatment.

Despite assessments, many women with perinatal mood and anxiety disorders remained untreated.

Abstract

Although California is regarded as a leader in reproductive freedoms and healthcare within the United States, Black women experience persistent inequities in perinatal mental healthcare. Despite healthcare system involvement, a significant proportion of Black women experiencing symptoms of perinatal mood and anxiety disorders (PMADs) go untreated. The purpose of this study was to 1) characterize clinician screening practices for PMADs; 2) describe the extent of perinatal mental health needs; and 3) identify factors within health systems that influence receipt of mental health services among Black women who lived in Los Angeles County, California throughout the perinatal period.

Secondary analysis of cross-sectional data from the Black Mothers’ Mental Wellness Study. The sample consisted of 110 Black women who self-reported either experiencing PMAD symptoms or being recently diagnosed with a PMAD. Results: Most of the sample received a clinical assessment for depression during pregnancy (78.2%, n=86) or after childbirth (70.0%, n=77). Among those who received a depression assessment, a nurse most often performed the screening. Among the 102 participants who experienced or were diagnosed with a PMAD throughout the perinatal period, 80 (78.4%) received mental health services, including counseling/therapy, support groups, or prescribed medication. Black women who received education about postpartum depression during pregnancy or after childbirth (OR=5.1, CI=-1.64-11.85) had almost 5 times higher odds of receiving mental health treatment than those who had not.

The findings from this analysis emphasize a gap in standard obstetric practice, which may result in undetected and untreated PMAD symptoms. Findings also highlighted the role of nurses in obstetric care, as well as the importance of anticipatory guidance regarding PMADs for Black women in Los Angeles County.