title: Barriers to mental health treatment among obstetric patients at risk for depression.
abstract: OBJECTIVE
  The objective of the study was to examine mental health referrals outcomes among obstetric patients at risk for depression.
  
  
  METHODS
  Fifty-one perinatal women who were offered mental health referrals were queried about their behaviors at 4 steps in the treatment engagement process and factors facilitating or impeding each step.
  
  
  RESULTS
  Although 59% of at-risk women accepted mental health referrals, only 27% ultimately engaged in treatment. Women who proactively sought help via a hotline were more likely to accept referrals (P < .001), contact a referred provider (P < .001), and engage in treatment (P < .05) than those who received unsolicited referrals after screening at-risk for depression. Barriers to successful treatment linkage were identified at the patient, provider, and system levels.
  
  
  CONCLUSIONS
  Only a minority of women who are at risk for perinatal depression and receive mental health referrals ultimately engage in treatment. Successful linkage may be enhanced via interventions targeting identified barriers; such interventions require prospective evaluation.
authors.affiliation: Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Chicago, IL, USA. jkim@northshore.org
authors.forename: J Jo
authors.initials: JJ
authors.lastname: Kim
authors.forename: Laura M
authors.initials: LM
authors.lastname: La Porte
authors.forename: Mariah
authors.initials: M
authors.lastname: Corcoran
authors.forename: Susan
authors.initials: S
authors.lastname: Magasi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Batza
authors.forename: Richard K
authors.initials: RK
authors.lastname: Silver
mesh_terms: D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D015277:Hotlines; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010358:Patient Participation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology / Q000628:therapy*; D012017:Referral and Consultation; D012306:Risk