Top

Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-07-2015 | Original Article

Mental Health Care Among Low-Income Pregnant Women with Depressive Symptoms: Facilitators and Barriers to Care Access and the Effectiveness of Financial Incentives for Increasing Care

Authors: Rebecca M. Sacks, Jessica Greene, Ryan Burke, Erin C. Owen

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 4/2015

Abstract

Access to mental health care is suboptimal for low-income pregnant women. Using in-depth interviews, we examined barriers and facilitators to accessing care among 42 low income pregnant women with depressive symptoms. To pilot whether financial incentives would increase utilization during pregnancy, half the women were randomized to receive $10 gift cards after mental health visits. Women reported external and internal barriers to accessing mental health care, and internal and interpersonal facilitators. Financial incentives did not impact how often the women visited mental health providers, suggesting that small incentives are not sufficient to catalyze mental health care use for this population.

Available only for authorised users

Austin, M. P., Priest, S. R., & Sullivan, E. A. (2008). Antenatal psychosocial assessment for reducing perinatal mental health morbidity. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD005124.pub2.PubMedCentralPubMed

Christensen, H., Griffiths, K. M., & Jorm, A. F. (2004). Delivering interventions for depression by using the internet: Randomised controlled trial. BMJ. doi:10.1136/bmj.37945.566632.EE.

Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.PubMedCrossRef

Cutler, C. B., Legano, L. A., Dreyer, B. P., Fierman, A. H., Berkule, S. B., Lusskin, S. I., et al. (2007). Screening for maternal depression in a low education population using a two item questionnaire. Archives of Women’s Mental Health, 10, 277–283. doi:10.1007/s00737-007-0202-z.PubMedCrossRef

Deci, E. L., Koestner, R., & Ryan, R. M. (1999). A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychology Bulletin, 125(6), 627–668.CrossRef

Donatelle, R., Hudson, D., Dobie, S., Goodall, A., Hunsberger, M., & Oswald, K. (2004). Incentives in smoking cessation: Status of the field and implications for research and practice with pregnant smokers. Nicotine & Tobacco Research, 6(Suppl 2), S163–S179. doi:10.1080/14622200410001669196.CrossRef

Donatelle, R. J., Prows, S. L., Champeau, D., & Hudson, D. (2000). Randomised controlled trial using social support and financial incentives for high risk pregnant smokers: Significant other supporter (SOS) program. Tobacco Control, 9(Suppl 3), III67–III69.PubMedCentralPubMed

Feinberg, E., Smith, M. V., Morales, M. J., Claussen, A. H., Smith, D. C., & Perou, R. (2006). Improving women’s health during internatal periods: Developing an evidenced-based approach to addressing maternal depression in pediatric settings. Journal of Women’s Health (Larchmt), 15(6), 692–703. doi:10.1089/jwh.2006.15.692.CrossRef

Field, T., Hernandez-Reif, M., & Diego, M. (2011). Depressed mothers’ newborns are less responsive to animate and inanimate stimuli. Infant and Child Development, 20(1), 94–105.CrossRef

Flynn, H. A., Blow, F. C., & Marcus, S. M. (2006). Rates and predictors of depression treatment among pregnant women in hospital-affiliated obstetrics practices. General Hospital Psychiatry, 28(4), 289–295. doi:10.1016/j.genhosppsych.2006.04.002.PubMedCrossRef

Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1), 1071–1083. doi:10.1097/01.AOG.0000183597.31630.db.PubMedCrossRef

Giacomini, M. K., Cook, D. J., & Evidence-Based Medicine Working Group. (2000). Users’ guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? JAMA, 284(3), 357–362.

Goodman, J. H., & Tyer-Viola, L. (2010). Detection, treatment, and referral of perinatal depression and anxiety by obstetrical providers. Journal of Women’s Health (Larchmt), 19(3), 477–490. doi:10.1089/jwh.2008.1352.CrossRef

Greene, J. (2011). Using consumer incentives to increase well-child visits among low-income children. Medical Care Research and Review, 68(5), 579–593. doi:10.1177/1077558711398878.PubMedCrossRef

Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67(10), 1012–1024. doi:10.1001/archgenpsychiatry.2010.111.PubMedCentralPubMedCrossRef

Health Coverage and Uninsured: Distribution of Nonelderly with Medicaid by Race/Ethnicity. (2011). State Health Facts.

Higgins, S. T., Washio, Y., Heil, S. H., Solomon, L. J., Gaalema, D. E., Higgins, T. M., et al. (2012). Financial incentives for smoking cessation among pregnant and newly postpartum women. Preventive Medicine, 55(Suppl), S33–S40. doi:10.1016/j.ypmed.2011.12.016.PubMedCentralPubMedCrossRef

Jeffery, R. W. (2012). Financial incentives and weight control. Preventive Medicine, 55(Suppl), S61–S67. doi:10.1016/j.ypmed.2011.12.024.PubMedCentralPubMedCrossRef

John, L. K., Loewenstein, G., Troxel, A. B., Norton, L., Fassbender, J. E., & Volpp, K. G. (2011). Financial incentives for extended weight loss: A randomized, controlled trial. Journal of General Internal Medicine, 26(6), 621–626. doi:10.1007/s11606-010-1628-y.PubMedCentralPubMedCrossRef

Kane, R. L., Johnson, P. E., Town, R. J., & Butler, M. (2004). A structured review of the effect of economic incentives on consumers’ preventive behavior. American Journal of Preventive Medicine, 27(4), 327–352.PubMedCrossRef

Kessler, R. C., McGonagle, K. A., Swartz, M., Blazer, D. G., & Nelson, C. B. (1993). Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. Journal of Affective Disorders, 29(2–3), 85–96.PubMedCrossRef

Kopelman, R. C., Moel, J., Mertens, C., Stuart, S., Arndt, S., & O’Hara, M. W. (2008). Barriers to care for antenatal depression. Psychiatric Services (Washington, D. C.), 59(4), 429–432. doi:10.1176/appi.ps.59.4.429.CrossRef

Lee, A. M., Lam, S. K., Lau, S. M. S. M., Chong, C. S. Y., Chui, H. W., & Fong, D. Y. T. (2007). Prevalence, course, and risk factors for antenatal anxiety and depression. Obstetrics & Gynecology, 110(5), 1102–1112. doi:10.1097/01.AOG.0000287065.59491.70.CrossRef

Loewenstein, G., Asch, D. A., & Volpp, K. G. (2013). Behavioral economics holds potential to deliver better results for patients, insurers, and employers. Health Affairs (Millwood), 32(7), 1244–1250. doi:10.1377/hlthaff.2012.1163.CrossRef

Löwe, B., Kroenke, K., & Gräfe, K. (2005). Detecting and monitoring depression with a two-item questionnaire (PHQ-2). Journal of Psychosomatic Research, 58(2), 163–171. doi:10.1016/j.jpsychores.2004.09.006.PubMedCrossRef

Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women’s Health (Larchmt), 12(4), 373–380. doi:10.1089/154099903765448880.CrossRef

Medicaid Incentives for Prevention of Chronic Diseases. (2011). Centers for Medicare and Medicaid Services Center for Strategic Planning. http://innovation.cms.gov.

O’Mahen, H., & Flynn, H. (2008a). Preferences and perceived barriers to treatment for mood disorders during the perinatal period. Journal of Women’s Health, 17(8), 1301–1309.PubMedCrossRef

O’Mahen, H. A., & Flynn, H. A. (2008b). Preferences and perceived barriers to treatment for depression during the perinatal period. Journal of Women’s Health (Larchmt), 17(8), 1301–1309. doi:10.1089/jwh.2007.0631.CrossRef

Sandelowski, M. (2000). Whatever happened to qualitative description. Research in Nursing & Health, 23, 334–340.CrossRef

Volpp, K. G., Levy, A. G., Asch, D. A., Berlin, J. A., Murphy, J. J., Gomez, A., et al. (2006). A randomized controlled trial of financial incentives for smoking cessation. Cancer Epidemiology, Biomarkers & Prevention, 15(1), 12–18.CrossRef

Volpp, K. G., Loewenstein, G., Troxel, A. B., Doshi, J., Price, M., Laskin, M., et al. (2008). A test of financial incentives to improve warfarin adherence. BMC Health Services Research, 8, 272. doi:10.1186/1472-6963-8-272.PubMedCentralPubMedCrossRef

Volpp, K. G., Troxel, A. B., Pauly, M. V., Glick, H. A., Puig, A., Asch, D. A., et al. (2009). A randomized, controlled trial of financial incentives for smoking cessation. The New England Journal of Medicine, 360(7), 699–709. doi:10.1056/NEJMsa0806819.PubMedCrossRef

Zenner, D., Molinar, D., Nichols, T., Riha, J., Macintosh, M., & Nardone, A. (2012). Should young people be paid for getting tested? A national comparative study to evaluate patient financial incentives for chlamydia screening. BMC Public Health, 12, 261. doi:10.1186/1471-2458-12-261.PubMedCentralPubMedCrossRef

Title: Mental Health Care Among Low-Income Pregnant Women with Depressive Symptoms: Facilitators and Barriers to Care Access and the Effectiveness of Financial Incentives for Increasing Care
Authors: Rebecca M. Sacks
Jessica Greene
Ryan Burke
Erin C. Owen
Publication date: 01-07-2015
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 4/2015
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-014-0562-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mental Health Care Among Low-Income Pregnant Women with Depressive Symptoms: Facilitators and Barriers to Care Access and the Effectiveness of Financial Incentives for Increasing Care

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2015

Users’ and Health Professionals’ Values in Relation to a Psychiatric Intervention: The Case of Psychiatric Advance Directives

Referral to Inpatient Treatment Does not Necessarily Imply a Need for Inpatient Treatment

Motivational Interviewing in Permanent Supportive Housing: The Role of Organizational Culture

Predictors of Use of Evidence-Based Practices for Children and Adolescents in Usual Care

Mental Health Care and Average Happiness: Strong Effect in Developed Nations

Iraq and Afghanistan War Veterans with Reintegration Problems: Differences by Veterans Affairs Healthcare User Status