In the Journals

Policymakers urged to improve perinatal depression treatment for minorities

In a position paper published in Women’s Health Issues, researchers issued policymakers a “call to action” to address the high rates of perinatal depression among Latina and African American women in the United States, urging funding to properly train health care providers in diagnosis and treatment.

“Despite the number of reliable screening tools and national efforts at increasing detection of [perinatal depression], rates of diagnosis and treatment continue to be low among Latinas and African American women,” Sandraluz Lara-Cinisomo, PhD, assistant professor, University of Illinois at Urbana-Champaign, and colleagues wrote. “Stigma and limited access to psychoeducation about [perinatal depression] might help to explain these disparities. Although these factors have been explored individually, they have not been examined simultaneously, limiting our understanding of their effect.”

Prior research has shown that many pregnant women with mental health issues are often stigmatized and worry about losing their child if they admit depressive symptoms to their doctors. Among Latina and African American women, this fear is complicated by cultural expectations that may limit treatment seeking and promote self-blame, according to Lara-Cinisomo and colleagues.

To improve diagnosis and treatment of perinatal depression in this vulnerable population, the authors recommend health care providers build patient trust by educating them on the symptoms, its high prevalence and its treatability. Public campaigns do not provide the trusting interaction women with perinatal depression need, so providing psychoeducation from a trusted source can help decrease stigma and increase diagnosis and access to the correct treatments, according to the authors.

“Reminding women that [perinatal depression] is not their fault and can be treated will also reduce shame and stigma, especially given the increased risk that Latinas and African American women will blame themselves when diagnosed,” they wrote. “To further minimize the effects of stigma, it is recommended that practitioners be aware of these cultural differences and ask about mood symptoms that patients might not initially disclose.”

To make sure psychoeducation programs increase screening and treatment of perinatal depression in Latina and African American women, Lara-Cinsomo and colleagues recommend OB-GYNs, family medicine providers, physician assistants, nurses and mental health providers receive the right training and equipment to give these patients the information and resources they need, preferably before they deliver. Information provided to this population should include the effectiveness of several interventions/treatments, cost and privacy as well as medication side effects and safety for both the mother and child in English and Spanish, the authors advise.

Additionally, more mental health providers who know how to care for underserved perinatal women, along with services and programs that are aware of cultural beliefs, are necessary to improve diagnosis and treatment adherence, Lara-Cinsomo and colleagues wrote.

“Given the need for more psychoeducation and training of key health care providers, we call to action policymakers and recommend they direct funds to build capacity among health care providers via the training described herein,” the authors wrote. “Additionally, federal, state and local funding should be directed at building capacity by providing funding for education and training of perinatal health professionals at all levels. Strategies that include early and frequent psychoeducation in primary care settings for perinatal Latinas and African American women are likely to increase diagnosis.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.

In a position paper published in Women’s Health Issues, researchers issued policymakers a “call to action” to address the high rates of perinatal depression among Latina and African American women in the United States, urging funding to properly train health care providers in diagnosis and treatment.

“Despite the number of reliable screening tools and national efforts at increasing detection of [perinatal depression], rates of diagnosis and treatment continue to be low among Latinas and African American women,” Sandraluz Lara-Cinisomo, PhD, assistant professor, University of Illinois at Urbana-Champaign, and colleagues wrote. “Stigma and limited access to psychoeducation about [perinatal depression] might help to explain these disparities. Although these factors have been explored individually, they have not been examined simultaneously, limiting our understanding of their effect.”

Prior research has shown that many pregnant women with mental health issues are often stigmatized and worry about losing their child if they admit depressive symptoms to their doctors. Among Latina and African American women, this fear is complicated by cultural expectations that may limit treatment seeking and promote self-blame, according to Lara-Cinisomo and colleagues.

To improve diagnosis and treatment of perinatal depression in this vulnerable population, the authors recommend health care providers build patient trust by educating them on the symptoms, its high prevalence and its treatability. Public campaigns do not provide the trusting interaction women with perinatal depression need, so providing psychoeducation from a trusted source can help decrease stigma and increase diagnosis and access to the correct treatments, according to the authors.

“Reminding women that [perinatal depression] is not their fault and can be treated will also reduce shame and stigma, especially given the increased risk that Latinas and African American women will blame themselves when diagnosed,” they wrote. “To further minimize the effects of stigma, it is recommended that practitioners be aware of these cultural differences and ask about mood symptoms that patients might not initially disclose.”

To make sure psychoeducation programs increase screening and treatment of perinatal depression in Latina and African American women, Lara-Cinsomo and colleagues recommend OB-GYNs, family medicine providers, physician assistants, nurses and mental health providers receive the right training and equipment to give these patients the information and resources they need, preferably before they deliver. Information provided to this population should include the effectiveness of several interventions/treatments, cost and privacy as well as medication side effects and safety for both the mother and child in English and Spanish, the authors advise.

Additionally, more mental health providers who know how to care for underserved perinatal women, along with services and programs that are aware of cultural beliefs, are necessary to improve diagnosis and treatment adherence, Lara-Cinsomo and colleagues wrote.

“Given the need for more psychoeducation and training of key health care providers, we call to action policymakers and recommend they direct funds to build capacity among health care providers via the training described herein,” the authors wrote. “Additionally, federal, state and local funding should be directed at building capacity by providing funding for education and training of perinatal health professionals at all levels. Strategies that include early and frequent psychoeducation in primary care settings for perinatal Latinas and African American women are likely to increase diagnosis.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.