title: Antenatal psychosocial risk status and Australian women's use of primary care and specialist mental health services in the year after birth: a prospective study.
abstract: Poor mental health in the perinatal period can impact negatively on women, their infants and families. Australian State and Territory governments are investing in routine psychosocial assessment and depression screening with referral to services and support, however, little is known about how well these services are used. The aim of this paper is to report on the health services used by women for their physical and mental health needs from pregnancy to 12 months after birth and to compare service use for women who have been identified in pregnancy as having moderate-high psychosocial risk with those with low psychosocial risk.
  
  
  
  One hundred and six women were recruited to a prospective longitudinal study with five points of data collection (2-4 weeks after prenatal booking, 36 weeks gestation, 6 weeks postpartum, 6 months postpartum and 12 months postpartum) was undertaken. Data were collected via face-to-face and telephone interviews, relating to psychosocial risk factors, mental health and service use. The prenatal psychosocial risk status of women (data available for 83 of 106 women) was determined using the Antenatal Risk Questionnaire (ANRQ) and was used to compare socio-demographic characteristics and service use of women with 'low' and 'moderate to high' risk of perinatal mental health problems.
  
  
  
  The findings indicate high use of postnatal universal health services (child and family health nurses, general practitioners) by both groups of women, with limited use of specialist mental health services by women identified with moderate to high risk of mental health problems. While almost all respondents indicated that they would seek help for mental health concerns most had a preference to seek help from partners and family before accessing health professionals.
  
  
  
  These preliminary data support local and international studies that highlight the poor uptake of specialist services for mental health problems in postnatal women, where this may be required. Further research comparing larger samples of women (with low and psychosocial high risk) are needed to explore the extent of any differences and the reasons why women do not access these specialist services.
authors: School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797 Penrith, Sydney, 2751, NSW, Australia. v.schmied@westernsydney.edu.au.
authors: Virginia
authors: 0000-0002-4066-1781
authors: V
authors: Schmied
authors: School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797 Penrith, Sydney, 2751, NSW, Australia.|Centre for Applied Nursing Research (a joint facility of the South Western Sydney Local Health District and Western Sydney University, Liverpool, Australia.|The Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia.
authors: Rachel
authors: R
authors: Langdon
authors: School of Psychology, University of Sydney and Research Director, Infant, Child & Adolescent Mental Health Service, South West Sydney Local Health District, Sydney, Australia.
authors: Stephen
authors: S
authors: Matthey
authors: School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797 Penrith, Sydney, 2751, NSW, Australia.
authors: Lynn
authors: L
authors: Kemp
authors: Chair, Perinatal Mental Health Unit University of New South Wales & St John of God Health Care, Burwood , Sydney, Australia.|The Black Dog Institute, Prince of Wales Hospital, Sydney, Australia.
authors: Marie-Paule
authors: MP
authors: Austin
authors: Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia.|The Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia.
authors: Maree
authors: M
authors: Johnson
mesh_terms: D001315:Australia / Q000453:epidemiology; D019052:Depression, Postpartum / Q000453:epidemiology; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008137:Longitudinal Studies; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Child and family health nursing; General practice; Health services research; Mental health services; Midwifery; Perinatal mental health; Service utilisation