By Slawa Rokicki, Mitu Patel, Patricia Suplee, and Robyn D’Oria
Perinatal mental health, which includes depression or anxiety that occurs during pregnancy or in the postpartum period, is a significant public health problem that disproportionately affects racial and ethnic minority groups. Data from the 2022 New Jersey Pregnancy Risk Assessment Monitoring Survey finds that nearly 27% of Asian women, 15% of non-Hispanic Black women, and 10% of Hispanic women report postpartum depressive symptoms, compared to 7% of non-Hispanic White women. Moreover, Black and Hispanic people are less likely to be screened for perinatal depression and are less likely to access treatment.
In an academic-community partnership between Rutgers School of Public Health and Central Jersey Family Health Consortium, we conducted a community needs assessment to better understand disparities in perinatal mental health in New Jersey. Within this project, which is funded by the New Jersey Alliance for Clinical and Translational Science, we conducted qualitative research as well as a rigorous assessment of current state and community services.
In our first study, we explored the lived experiences of women with perinatal depression or anxiety during the COVID-19 pandemic. Our analysis revealed that the increased financial stress and social isolation brought on by the pandemic magnified symptoms while disrupting access to mental health care. Yet the pandemic also created a window of opportunity to expand telehealth services, which many women in our study reported reduced their barriers, such as finding childcare and transportation, to accessing psychotherapy and other mental health care services.
In addition to traditional mental health services, peer support and other community-based programs are essential tools for the prevention and treatment of perinatal depression. In our second study, we conducted a survey to assess the availability of community-based perinatal mental health programs in New Jersey. Results indicated that 82% of programs have been offering virtual or telephone-based options after the pandemic. Nevertheless, disparities in access persist. We found that in the majority of community programs, Black, Hispanic, and Asian individuals made up less than 10% of total annual participants, and less than 10% of facilitators represented those racial/ethnic groups. Stigma and fear of disclosure of mental health challenges, lack of support from family, and lack of language-concordant options were significant barriers impacting racial and ethnic minorities’ participation in these programs.
Disparities in perinatal mental health in New Jersey reflect the systemic gaps in equity, access, and infrastructure of the larger U.S. health care system. Policies to expand telehealth access, diversify the perinatal mental health workforce, address stigma, and reduce social and economic inequality are critical to advancing perinatal mental health equity. Although much work remains, New Jersey has made some progress: in 2021, the state implemented Medicaid coverage for doula services, as well as signed legislation to create a universal home visiting program for all families within three weeks of bringing home a newborn, allowing for early detection and referral for mental health support and services as needed. However, more research is needed to test the effectiveness of these initiatives in reducing disparities in prevalence, diagnosis, and treatment of perinatal mental health conditions.
Affiliations:
Slawa Rokicki, Rutgers School of Public Health
Mitu Patel, Rutgers School of Public Health
Patricia Suplee, Rutgers University-Camden School of Nursing
Robyn D’Oria, Central Jersey Family Health Consortium