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

Kortney Floyd James; Keren Chen; Sasha Sharon Hindra; Monicque Landell; Kristen R Choi; Dana C Beck

doi:10.1186/s12884-025-08251-2

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

BMC Pregnancy Childbirth. 2025 Oct 15;25(1):1098. doi: 10.1186/s12884-025-08251-2.

Authors

Kortney Floyd James¹, Keren Chen², Sasha Sharon Hindra³, Monicque Landell⁴, Kristen R Choi^{5

6}, Dana C Beck⁵

Affiliations

¹ Department General Internal Medicines, David Geffen School of Medicine , University of California Los Angeles, National Clinician Scholars Program, 1100 Glendon Ave, Suite 900, Los Angeles, CA, 90024, USA. kfloydjames@gmail.com.
² Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, 855 Tiverton Dr, Los Angeles, CA, 90024, USA.
³ Sue & Bill Gross School of Nursing, University of California, Irvine, 854 Health Sciences Rd, Irvine, CA, 92697, USA.
⁴ Franklin & Marshall College, 637 College Avenue, Lancaster, PA, 17603, USA.
⁵ School of Nursing Los Angeles, University of California, Los Angeles, 700 Tiverton Dr, Los Angeles, CA, 90095, USA.
⁶ Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.

Abstract

Background: 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.

Methods: 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.

Conclusions: 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.

Keywords: Access to care; Black women; Healthcare systems; Mental health; Nursing; Obstetric care.

MeSH terms

Adult
Anxiety Disorders* / diagnosis
Anxiety Disorders* / ethnology
Anxiety Disorders* / therapy
Black or African American* / psychology
Black or African American* / statistics & numerical data
Cross-Sectional Studies
Depression, Postpartum* / diagnosis
Depression, Postpartum* / ethnology
Depression, Postpartum* / therapy
Female
Healthcare Disparities / ethnology
Humans
Los Angeles
Mental Health Services* / statistics & numerical data
Mood Disorders* / diagnosis
Mood Disorders* / ethnology
Mood Disorders* / therapy
Perinatal Care* / statistics & numerical data
Pregnancy
Pregnancy Complications* / diagnosis
Pregnancy Complications* / ethnology
Pregnancy Complications* / psychology
Pregnancy Complications* / therapy
Young Adult

Abstract

MeSH terms

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