Racial/ethnic differences in mental health treatment among a national sample of pregnant women with mental health and/or substance use disorders in the United States

J Psychosom Res. 2019 Jun:121:74-80. doi: 10.1016/j.jpsychores.2019.03.015. Epub 2019 Mar 16.

Abstract

Objective: To examine racial/ethnic differences in the receipt of mental health treatment among pregnant women with mental health (i.e., depression and serious psychological distress) and/or substance use disorders.

Method: Secondary analysis of data from the National Survey on Drug Use and Health was conducted. The sample consisted of 1232 pregnant women with mental health/substance use disorders.

Results: Black/African American (Adjusted Odds Ratio [AOR]: 0.36, 95% Confidence Interval [CI]: 0.17-0.75), other non-Hispanic (AOR: 0.24, 95% CI: 0.11-0.52), and Hispanic (AOR: 0.42, 95% CI: 0.22-0.81) pregnant women had significantly lower odds of mental health treatment receipt compared to Whites, even when controlling for age, education, marital status, number of children, employment status, income, health insurance, county urbanicity, self-rated health status, type of mental health condition, and time. There were no racial/ethnic differences by mental health and/or substance use disorders. Among pregnant women who perceived unmet mental health treatment need (N = 299), a greater proportion of White compared to Non-White pregnant women perceived cost as an obstacle to access treatment (62.1% vs. 35.6%, p = .001); however, the two groups did not differ in other perceived barriers to mental health treatment (i.e., opposition to treatment, stigma, time/transportation limitation, and not knowing where to go).

Conclusions: Strategies are needed to increase access to mental health treatment among racial/ethnic minority women who are pregnant and have mental health/substance use disorders. Further studies are required to understand racial/ethnic differences in the perceived barriers to mental health treatment.

Keywords: Mental health treatment; National sample; Pregnant women; Racial/ethnic differences.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Depression / epidemiology
  • Depression / ethnology
  • Depression / psychology
  • Depression / therapy
  • Ethnicity / psychology*
  • Female
  • Humans
  • Income
  • Male
  • Marital Status
  • Mental Health / ethnology*
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Odds Ratio
  • Pregnancy
  • Psychotherapy
  • Racial Groups / psychology*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / ethnology*
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*
  • United States / epidemiology
  • United States / ethnology
  • Young Adult