Pregnant women with a major depressive episode were less likely to receive mental health care than nonpregnant women with a major depressive episode, according to a study published in Psychiatry Services.

Investigators abstracted data from the 2011-2016 National Survey on Drug Use and Health (NSDUH), a nationally representative survey of the noninstitutionalized US population. Certain NSDUH questions assess the symptoms of major depressive disorder per criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The NSDUH also captures mental health treatment use, unmet mental health care need, and the reasons for unmet mental health care needs among respondents. Pregnancy status was also reported. Investigators used descriptive statistics to compare differences between pregnant and nonpregnant women who had experienced a major depressive episode.

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The final study cohort included 12,360 women of reproductive age who had experienced a major depressive episode (360 pregnant). Just 49% of pregnant women reported receiving any mental health treatment compared with 57% of nonpregnant women (P <.001). In addition, 40% of pregnant women reported perceiving an unmet need for mental health treatment, regardless of whether they had received treatment. Among nonpregnant women with a major depressive episode, just 34% perceived an unmet need for mental health treatment (P <.001).

For both pregnant and nonpregnant women with a major depressive episode, financial concerns were the primary reason for unmet treatment need, followed by “structural reasons,” including transportation difficulties and inconvenient treatment location.

Most pregnant women who perceived an unmet need for mental health treatment had lower income (66%), were non-Hispanic whites (71%), were unmarried, had children younger than 18 years, and received public health insurance benefits. In addition, pregnant women were more likely to be working and to have a household family income below $20,000.

These data underscore an unmet need for mental health treatment among pregnant women in the United States, particularly those of lower income. Mental health interventions must address financial and structural barriers to accommodate these women in need.

Reference

Sanmartin MX, Ali MM, Chen J, Dwyer DS. Mental health treatment and unmet mental health care need among pregnant women with major depressive episode in the United States [published online April 10, 2019]. Psychiatr Serv. doi: 0.1176/appi.ps.201800433