title: The impact of routine assessment of past or current mental health on help-seeking in the perinatal period.
abstract: BACKGROUND
  Clinical practice guidelines now recommend that women be asked about their past or current mental health as a routine component of maternity care. However, the value of this line of enquiry in increasing engagement with support services, as required, remains controversial.
  
  
  OBJECTIVE
  The current study aimed to examine whether assessment of past or current mental health, received with or without referral for additional support, is associated with help-seeking during pregnancy and the postpartum.
  
  
  METHODS
  A subsample of women drawn from the Australian Longitudinal Study on Women's Health (young cohort) who reported experiencing significant emotional distress during pregnancy (N=398) or in the 12 months following birth (N=380) participated in the study.
  
  
  RESULTS
  Multivariate analysis showed that women who were not asked about their emotional health were less likely to seek any formal help during both pregnancy (adjOR=0.09, 95%CI: 0.04-0.24) and the postpartum (adjOR=0.07, 95%CI: 0.02-0.13), as were women who were asked about these issues but who were not referred for additional support (antenatal: adjOR=0.26, 95%CI: 0.15-0.45; postnatal: adjOR=0.14, 95%CI: 0.07-0.27). However, considerable levels of consultation with general practitioners, midwives and child health nurses, even in the absence of referral, were evident.
  
  
  CONCLUSIONS
  This study demonstrates that enquiry by a health professional about women's past or current mental health is associated with help-seeking throughout the perinatal period. The clinical and resource implications of these findings for the primary health care sector should be considered prior to the implementation of future routine perinatal depression screening or psychosocial assessment programmes.
authors.affiliation: Perinatal and Women's Mental Health Unit, St John of God Health Care and University of New South Wales, PO Box 261, Burwood, NSW 1805, Australia. Electronic address: n.reilly@unsw.edu.au.
authors.forename: Nicole
authors.initials: N
authors.lastname: Reilly
authors.affiliation: Australian Longitudinal Study on Women's Health, Research Centre for Gender, Health & Ageing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
authors.forename: Sheree
authors.initials: S
authors.lastname: Harris
authors.affiliation: Australian Longitudinal Study on Women's Health, Research Centre for Gender, Health & Ageing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Loxton
authors.affiliation: Australian Longitudinal Study on Women's Health, Research Centre for Gender, Health & Ageing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Chojenta
authors.affiliation: Australian Longitudinal Study on Women's Health, Research Centre for Gender, Health & Ageing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
authors.forename: Peta
authors.initials: P
authors.lastname: Forder
authors.affiliation: Perinatal and Women's Mental Health Unit, St John of God Health Care and University of New South Wales, PO Box 261, Burwood, NSW 1805, Australia; The Black Dog Institute, Hospital Dr, Randwick, NSW 2031, Australia.
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Austin
mesh_terms: D000328:Adult; D001315:Australia; D004644:Emotions; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy; D008603:Mental Health; D008880:Midwifery; D015999:Multivariate Analysis; D036801:Parturition / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D018743:Perinatal Care / Q000379:methods* / Q000706:statistics & numerical data; D011247:Pregnancy; D011320:Primary Health Care / Q000458:organization & administration; D011369:Professional-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Help seeking; Perinatal; Psychosocial assessment; Referral; Screening