Mental health services for maternal depression: A need for system-level change

Abstract

ABSTRACTIntroduction: Women who are impacted by poverty are at heightened risk for depression, yet are unlikely to engage in mental health services due to to practical and perceptual barriers about treatment, including transportation and childcare difficulties, and misperceptions about mental health providers and treatment. The mental health service system has also been shown to limit access due to a lack of providers, extensive wait lists for services, and language barriers. The purpose of this study was to examine agency-level barriers to treatment among a poverty-impacted sample of women with depressive symptoms, as well as any supports that agencies have implemented to engage consumers into services.Method: This study conducted an environmental scan of mental health agencies and practitioners within three districts comprising nine zip codes representing the most socioeconomically disadvantaged areas in Harlem, New York. Following a standardized script, 46 private practitioners (n=27) and agencies (n=19) located within these zip codes provided information about their services, wait times, and any supports they offered consumers to attend.Results: Private practitioners were statistically less likely to accept insurance than agencies, yet agencies had significantly greater waitlists for services, particularly for Spanish-speaking clients. Few private practitioners offered services in Spanish, or offered affordable treatment (less than $100 per session). Only two agencies offered transportation vouchers; no other supports were offered by either private practitioners or agencies.Discussion: Mental health care remains largely inaccessible for mothers living in poverty, particularly if they are Spanish speaking. Systems-level changes are needed in order to provider affordable, accessible treatment and ultimately reduce the risk of maternal depression upon the family.