Mental health and substance use disorders and treatment receipt among pregnant women in the United States, 2008-2014 : trend analysis, likelihood of treatment receipt, and ethnic disparities in mental health treatment.

Abstract

Pregnant women and their children are at risk for devastating health consequences when pregnancy is associated with poor mental health and substance use problems. Yet, most of what is known about these significant issues in pregnant women came from clinical samples which limits the generalizability of the findings to the national population. Therefore, the purposes of this dissertation were to examine trends from 2008 to 2014 in mental health and substance use disorders and treatment receipt, and explore factors associated with treatment receipt in pregnant women aged 18-44 years in the United States. This dissertations contains three manuscripts: (1) a systematic review of trend and population-based studies on mental health and substance use disorders and treatment receipt in pregnant women in the United States; (2) a trend study on mental health and substance use disorders and treatment receipt among pregnant and nonpregnant women in the United States from 2008 to 2014; and (3) a population-based 521 with substance use disorders) who were 18-44 years old. The best predictors of viii receipt of mental health treatment included: past-year anxiety disorder, major depressive episode, serious psychological distress, college education, health insurance coverage, and White ethnicity. Predictors of substance use treatment receipt were: illicit drug abuse and dependence, alcohol dependence, comorbid anxiety/depression, White ethnicity, and urban residency. Compared to Whites, nonWhite pregnant women with major depressive episode, serious psychological distress, substance use disorders, and/or comorbid mental health and substance use disorders had lower odds of receiving mental health treatment. The findings of this dissertation indicate that there is a gap between the need and the receipt of mental health and substance use treatment in pregnant women. Improved recognition and access to treatment for mental health and substance use disorders in this vulnerable population is critical. Preventive and interventional strategies are required to address the mental health needs of ethnic minority pregnant women with mental health and/or substance use disorders.