| Description |
Medicaid insures the majority of childbearing women visiting public health departments in rural Utah. A majority of these women live below the state and federal poverty thresholds, and few have more than a high school education. It is important that health resources be tailored to meet the unique needs of this underserved population of women, especially throughout their childbearing years. A particular health concern that is often overlooked is maternal depression: Among women screening positive for perinatal depression and anxiety, as few as 24% reported having received mental health care at any point during or after pregnancy. Of those whose symptoms are known, previous statistics have shown that less than half receive treatment. Perinatal depression is one of the most common complications experienced by childbearing women in the United States, affecting approximately 14% of pregnancies in the general population and as many as 20% in high-risk populations. Depression during and after pregnancy has been linked to a variety of negative outcomes for both mothers and children, including decreased breastfeeding, low birthweight, preterm birth, gestational diabetes mellitus, and increased need for neonatal intensive care. Susceptibility to perinatal depression is increased in mothers with low income, poor social support, high levels of stress, domestic abuse, and a history of depression and anxiety. Women residing in rural areas have been shown to experience these risk factors at an increased rate, thus placing them at high risk for developing perinatal depression. Additionally, factors intrinsic to rural life, including transportation barriers and insufficient health care resources, may further reduce a woman's ability to access necessary mental health services. The purpose of this study is to identify barriers to accessing mental health care for women suffering from perinatal depression in rural Utah. Data were collected via a 30- item survey, the Perceived Access Inventory (PAI) for Maternal Mental Health Services, which was administered electronically. The questionnaire was exclusively offered to mothers up to one year postpartum who had previously screened positive for perinatal depression or anxiety during visits to public health clinics in four rural Utah health districts. Survey questions addressed barriers in five domains: logistics, culture, digital resources, systems of care, and experiences of care in relation to accessing mental health services. The total number of individuals surveyed was 17, nine of whom were covered by Medicaid and two of whom were uninsured. Of those surveyed, 94% had annual incomes under $50,000 and 56% earned less than $30,000. Despite the small sample size, this survey population is largely representative of the population of childbearing women in rural Utah who rely on care from public health clinics. Results of the PAI indicate that only 24% of respondents were successful in acquiring necessary mental health care. Significant barriers identified include providerto- patient communication and referral, insurance and financial constraints, and perceived stigma or fear of consequences. With the help of this analysis and additional research to come, change can begin within the healthcare system to address the pressing issue of mental health care accessibility for mothers and rural inhabitants at large. |
