title: Disclosure during prenatal mental health screening.
abstract: BACKGROUND
  While women and healthcare providers have generally viewed perinatal mental health screening favorably, some qualitative studies suggest that some women intentionally decide not to reveal their symptoms during screening.
  
  
  OBJECTIVE
  The purpose of this study was to describe women's reported willingness to disclose mental health concerns during screening and factors associated with this.
  
  
  METHODS
  This cross-sectional study included pregnant women who were >16 years of age and could speak/read English. Women were recruited from five maternity clinics and two community hospitals in Alberta, Canada (May-December, 2013). Eligible women completed the online Barriers and Facilitators of Mental Health Screening Questionnaire on recruitment. The primary outcome for this analysis was women's level of honesty about mental health concerns (completely vs somewhat/not at all honest) during screening. Analyses included descriptive statistics and multivariable logistic regressions to identify factors associated with honesty.
  
  
  RESULTS
  Participation rate was 92% (460/500). Seventy-nine percent of women indicated that they could be 'completely honest' during screening. Women who feared their provider would view them as bad mothers were less likely to be honest. We found a significant association between 'less anonymous' modes of screening and honesty.
  
  
  CONCLUSIONS
  Over eighty percent of women in this study were well-educated, partnered, Caucasian women. As such, generalizability of the study findings may be limited.
  
  
  CONCLUSIONS
  Most women indicated they could be honest during screening. Stigma-related factors and screening mode influenced women's willingness to disclose. Strategies to reduce stigma during screening are warranted to enhance early detection of prenatal mental illness.
authors.affiliation: Faculty of Nursing, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: dawn.kingston@ualberta.ca.
authors.forename: Dawn E
authors.initials: DE
authors.lastname: Kingston
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Ada and Slaight Family Director of Maternity Care, Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Biringer
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Amy
authors.initials: A
authors.lastname: Toosi
authors.affiliation: College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Maureen I
authors.initials: MI
authors.lastname: Heaman
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Gerri C
authors.initials: GC
authors.lastname: Lasiuk
authors.affiliation: Population, Public, and Aboriginal Health, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Sheila W
authors.initials: SW
authors.lastname: McDonald
authors.affiliation: Faculty of Science (Computer Science), MacEwan University, Edmonton, Alberta, Canada.
authors.forename: Joshua
authors.initials: J
authors.lastname: Kingston
authors.affiliation: School of Nursing and Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Wendy
authors.initials: W
authors.lastname: Sword
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Karly
authors.initials: K
authors.lastname: Jarema
authors.affiliation: St. John of God Chair Perinatal & Women's Mental Health, School of Psychiatry, University of New South Wales, Sydney, Australia.
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008603:Mental Health; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care; D012752:Shame; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014342:Truth Disclosure
keywords: Anxiety; Depression; Mental health; Pregnancy; Screening