This study delineated the unmet mental health needs of peripartum mothers with symptoms of depression, ascertained their willingness to engage in psychotherapy via text message, and identified potential determinants of that willingness (e.g., demographics, preferred communication methods) to inform improvement to service delivery.
Method:
This was a cross-sectional national survey of 897 adults who had given birth in the previous 24 months, had at least one lifetime symptom of depression, had internet access, and could read English. Univariate analysis was followed by multivariable Firth’s logistic regression.
Results:
Peripartum participants with at least one symptom of depression wanted mental health care the most within 2 years of giving birth (64.4%) and had less access to mental health care during pregnancy and postpartum (35.1% and 38.1%, compared with 23.9%). Fifty-three percent of participants were willing to engage in psychotherapy via text message. Determinants of willingness to engage in text message therapy for all periods (pregnancy, postpartum, and not peripartum) included wanting mental health treatment but not having access and previous experience with psychotherapy via text message. During pregnancy and not peripartum, more depressive symptoms were associated with willingness to engage in psychotherapy via text message.
Conclusion:
The peripartum period is an especially high-risk time for mothers to experience depressive symptoms. In general, most wanted therapy but were unable to access it. Most participants were willing to engage in text message therapy.
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References
1.
SalomonssonMW, SorjonenK, SalomonssonB. A longterm follow-up study of a randomized controlled trial of mother-infant psychoanalytic treatment outcomes on mothers and interactions: Mother-infant psychoanalytic treatment. Infant Ment Health J, 2015; 36(6):542–555; doi: 10.1002/imhj.21536
2.
TalatiA, WickramaratnePJ, PilowskyDJ, et al.Remission of maternal depression and child symptoms among single mothers: A STAR*D-Child report. Soc Psychiatry Psychiatr Epidemiol, 2007; 42(12):962–971; doi: 10.1007/s00127-007-0262-4
3.
WeissmanMM, PilowskyDJ, WickramaratnePJ, et al.STAR D-Child Team. Remissions in maternal depression and child psychopathology. JAMA, 2006; 295(12):1389–1398; doi: 10.1001/jama.295.12.1389
4.
SlomianJ, HonvoG, EmontsP, et al.Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Womens Health (Lond Engl), 2019; 15:174550651984404; doi: 10.1177/1745506519844044
5.
ShoreyS, CheeCYI, NgED, et al.Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. J Psychiatr Res, 2018; 104:235–248; doi: 10.1016/j.jpsychires.2018.08.001
6.
BasuA, KimHH, BasalduaR, et al.A cross-national study of factors associated with women’s perinatal mental health and wellbeing during the COVID-19 pandemic. PLoS One, 2021; 16(4):e0249780; doi: 10.1371/journal.pone.0249780
7.
ShawDS, ConnellA, DishionTJ, et al.Improvements in maternal depression as a mediator of intervention effects on early childhood problem behavior. Dev Psychopathol, 2009; 21(2):417–439; doi: 10.1017/S0954579409000236
8.
Da CostaD, DritsaM, RippenN, et al.Health-related quality of life in postpartum depressed women. Arch Womens Ment Health, 2006; 9(2):95–102; doi: 10.1007/s00737-005-0108-6
9.
VliegenN, CasalinS, LuytenP, et al.Hospitalization-based treatment for postpartum depressed mothers and their babies: Rationale, principles, and preliminary follow-up data. Psychiatry, 2013; 76(2):150–168; doi: 10.1521/psyc.2013.76.2.150
10.
BarrJA, BeckCT. Infanticide secrets: Qualitative study on postpartum depression. Can Fam Physician Med Fam Can, 2008; 54(12):1716–1717.e5.
11.
FarrSL, DietzPM, RizzoJH, et al.Health care utilisation in the first year of life among infants of mothers with perinatal depression or anxiety: Maternal mental health and infant health care utilisation. Paediatr Perinat Epidemiol, 2013; 27(1):81–88; doi: 10.1111/ppe.12012
12.
CurtisMA, CormanH, NoonanK, et al.Maternal depression as a risk factor for family homelessness. Am J Public Health, 2014; 104(9):1664–1670; doi: 10.2105/AJPH.2014.301941
13.
AliNS, MahmudS, KhanA, et al.Impact of postpartum anxiety and depression on child’s mental development from two peri-urban communities of Karachi, Pakistan: A quasi-experimental study. BMC Psychiatry, 2013; 13:274; doi: 10.1186/1471-244X-13-274
14.
KaplanPS, DankoCM, KalinkaCJ, et al.A developmental decline in the learning-promoting effects of infant-directed speech for infants of mothers with chronically elevated symptoms of depression. Infant Behav Dev, 2012; 35(3):369–379; doi: 10.1016/j.infbeh.2012.02.009
15.
KoutraK, ChatziL, BagkerisM, et al.Antenatal and postnatal maternal mental health as determinants of infant neurodevelopment at 18 months of age in a mother-child cohort (Rhea Study) in Crete, Greece. Soc Psychiatry Psychiatr Epidemiol, 2013; 48(8):1335–1345; doi: 10.1007/s00127-012-0636-0
16.
Sutter-DallayA-L, MurrayL, Dequae-MerchadouL, et al.A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development. Eur Psychiatry, 2011; 26(8):484–489; doi: 10.1016/j.eurpsy.2010.05.004
17.
QuevedoLA, SilvaRA, GodoyR, et al.The impact of maternal post-partum depression on the language development of children at 12 months: Depression post partum and language development of children. Child Care Health Dev, 2012; 38(3):420–424; doi: 10.1111/j.1365-2214.2011.01251.x
18.
PiteoAM, YellandLN, MakridesM. Does maternal depression predict developmental outcome in 18month old infants? Early Hum Dev, 2012; 88(8):651–655; doi: 10.1016/j.earlhumdev.2012.01.013
19.
HaningtonL, RamchandaniP, SteinA. Parental depression and child temperament: Assessing child to parent effects in a longitudinal population study. Infant Behav Dev, 2010; 33(1):88–95; doi: 10.1016/j.infbeh.2009.11.004
20.
MoehlerE, KaganJ, ParzerP, et al.Childhood behavioral inhibition and maternal symptoms of depression. Psychopathology, 2007; 40(6):446–452; doi: 10.1159/000107429
21.
GialloR, WoolhouseH, GartlandD, et al.The emotional–behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: A prospective Australian pregnancy cohort study. Eur Child Adolesc Psychiatry, 2015; 24(10):1233–1244; doi: 10.1007/s00787-014-0672-2
22.
HayDF, PawlbyS, WatersCS, et al.Mothers’ Antenatal depression and their children’s antisocial outcomes. Child Dev, 2010; 81(1):149–165; doi: 10.1111/j.1467-8624.2009.01386.x
23.
HayDF, PawlbyS, WatersCS, et al.Antepartum and postpartum exposure to maternal depression: Different effects on different adolescent outcomes. J Child Psychol Psychiatry, 2008; 49(10):1079–1088; doi: 10.1111/j.1469-7610.2008.01959.x
MolyneauxE, HowardLM, McGeownHR, et al.Antidepressant treatment for postnatal depression. Cochrane Database Syst Rev, 2014; 2014(9):CD002018; doi: 10.1002/14651858.CD002018.pub2
26.
GoodmanSH, GarberJ. Evidence-based interventions for depressed mothers and their young children. Child Dev, 2017; 88(2):368–377; doi: 10.1111/cdev.12732
27.
CoiroMJ, RileyA, BroitmanM, et al.Effects on children of treating their mothers’ depression: Results of a 12-month follow-up. Psychiatr Serv, 2012; 63(4):357–363; doi: 10.1176/appi.ps.201100126
28.
GarberJ, CieslaJA, McCauleyE, et al.Remission of depression in parents: Links to healthy functioning in their children: Remission of depression in parents. Child Dev, 2011; 82(1):226–243; doi: 10.1111/j.1467-8624.2010.01552.x
29.
ModellJD, ModellJG, WallanderJ, et al.Maternal ratings of child behavior improve with treatment of maternal depression. Fam Med, 2001; 33(9):691–695.
30.
CooperPJ, MurrayL, WilsonA, et al.Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: I. Impact on maternal mood. Br J Psychiatry, 2003; 182(5):412–419; doi: 10.1192/bjp.182.5.412
31.
SalomonssonB, KornarosK, SandellR, et al.Short‐term psychodynamic infant–parent interventions at Child health centers: Outcomes on parental depression and infant social–emotional functioning. Infant Ment Health J, 2021; 42(1):109–123; doi: 10.1002/imhj.21893
32.
HadfieldH, WittkowskiA. Women’s experiences of seeking and receiving psychological and psychosocial interventions for postpartum depression: A systematic review and thematic synthesis of the qualitative literature. J Midwifery Womens Health, 2017; 62(6):723–736; doi: 10.1111/jmwh.12669
33.
CopelandVC, SnyderK. Barriers to mental health treatment services for low-income African American women whose children receive behavioral health services: An ethnographic investigation. Soc Work Public Health, 2011; 26(1):78–95; doi: 10.1080/10911350903341036
LuptonD. The use and value of digital media for information about pregnancy and early motherhood: A focus group study. BMC Pregnancy Childbirth, 2016; 16(1):171; doi: 10.1186/s12884-016-0971-3
36.
GleesonDM, CraswellA, JonesCM. Women’s use of social networking sites related to childbearing: An integrative review. Women Birth, 2019; 32(4):294–302; doi: 10.1016/j.wombi.2018.10.010
37.
JohnsonSA. ‘Intimate mothering publics’: Comparing face-to-face support groups and Internet use for women seeking information and advice in the transition to first-time motherhood. Cult Health Sex, 2015; 17(2):237–251; doi: 10.1080/13691058.2014.968807
38.
MohrDC, WeingardtKR, ReddyM, et al.Three problems with current digital mental health research and three things we can do about them. Psychiatr Serv, 2017; 68(5):427–429; doi: 10.1176/appi.ps.201600541
39.
KesslerD, LewisG, KaurS, et al.Therapist-delivered internet psychotherapy for depression in primary care: A randomised controlled trial. Lancet, 2009; 374(9690):628–634.
40.
Alvarez-JimenezM, RiceS, D’AlfonsoS, et al.A novel multimodal digital service (Moderated Online Social Therapy+) for help-seeking young people experiencing mental ill-health: Pilot evaluation within a national youth e-mental health service. J Med Internet Res, 2020; 22(8):e17155; doi: 10.2196/17155
41.
FukkinkRG, HermannsJMA. Children’s experiences with chat support and telephone support. J Child Psychol Psychiatry, 2009; 50(6):759–766; doi: 10.1111/j.1469-7610.2008.02024.x
42.
ErsahinZ, HanleyT. Using text-based synchronous chat to offer therapeutic support to students: A systematic review of the research literature. Health Educ J, 2017; 76(5):531–543; doi: 10.1177/0017896917704675
43.
DowlingM, RickwoodD. Investigating individual online synchronous chat counselling processes and treatment outcomes for young people. Adv Ment Health, 2014; 12(3):216–224; doi: 10.1080/18374905.2014.11081899
44.
DowlingM, RickwoodD. A naturalistic study of the effects of synchronous online chat counselling on young people’s psychological distress, life satisfaction and hope. Couns Psychother Res, 2015; 15(4):274–283; doi: 10.1002/capr.12037
45.
DowlingM, RickwoodD. Online counseling and therapy for mental health problems: A systematic review of individual synchronous interventions using chat. J Technol Hum Serv, 2013; 31(1):1–21; doi: 10.1080/15228835.2012.728508
46.
ZerwasSC, WatsonHJ, HofmeierSM, et al.CBT4BN: A randomized controlled trial of online chat and face-to-face group therapy for bulimia nervosa. Psychother Psychosom, 2017; 86(1):47–53; doi: 10.1159/000449025
47.
HullTD, MalgaroliM, ConnollyPS, et al.Two-way messaging therapy for depression and anxiety: Longitudinal response trajectories. BMC Psychiatry, 2020; 20(1):297; doi: 10.1186/s12888-020-02721-x
48.
WulandariR, SuwandonoA, KartasuryaMI, et al.Postpartum care behavior improvement during COVID-19 pandemic in Indonesia using mobile-health interactive message. Ethiop J Health Sci, 2022; 32(2):243–254.
49.
SampathkumarS, SankarM, RamasamyS, et al.Uptake, engagement and acceptance, barriers and facilitators of a text messaging intervention for postnatal care of mother and child in India—A mixed methods feasibility study. Int J Environ Res Public Health, 2022; 19(15):8914; doi: 10.3390/ijerph19158914
50.
ChowR, HuangE, LiA, et al.Appraisal of systematic reviews on interventions for postpartum depression: Systematic review. BMC Pregnancy Childbirth, 2021; 21(1):18; doi: 10.1186/s12884-020-03496-5
51.
BernsteinSL, RosnerJ, TollB. A multicomponent intervention including texting to promote tobacco abstinence in emergency department smokers: A pilot study. Acad Emerg Med, 2016; 23(7):803–808; doi: 10.1111/acem.12990
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