Acceptability and Perceived Benefits and Harms of Mental Health Screening in Pregnant Women

Abstract

Perinatal mental healthcare in Canada is characterized by under-diagnosis and under-treatment. Approaches to mental health screening can influence pregnant women’s uptake of treatment services. To determine the acceptability of mental health screening in Canadian pregnant women. This cross-sectional survey used the Barriers and Facilitators of Mental Health Screening Survey. The study included pregnant women who read/spoke English. The survey was administered via computer-tablet to women recruited from prenatal classes and maternity clinics in Alberta. Analyses included descriptive statistics and multivariable regression. Respondents (n=459, 92% participation) were largely 25-34 years old (89%), Caucasian (83%), and partnered (95%). Almost two-thirds of women indicated they expected to be asked about mental health, with 35% reporting their provider asked. The majority (99.8%) indicated that they could be honest with their provider about their mental health if asked and 99.3% of those asked reported they were comfortable with screening. Women indicated a strong preference for routine screening, but identified sporadic assessment as threatening. Women were more likely to report screening as positive if: 1) they had been treated previously for depression/anxiety; or 2) they identified barriers to screening as: a) feeling worried that their concerns were unimportant to their provider; or b) feeling that their provider did not have time to talk about mental health. Women were less likely to report screening as positive if they expected their provider to ask about their mental health. Findings confirm women’s acceptability of routine prenatal mental health assessment. Results will inform decision-making regarding routine perinatal mental healthcare.