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Treatment and Management of Depression Symptoms in Pregnant Veterans: Varying Experiences of Mental Health Care in the Prenatal Period

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Abstract

Depression screening is recommended for all pregnant veterans; however, little is known on how often symptomatic women receive care, how depression treatment presents in practice, and whether women veterans are utilizing treatment during the appreciable perinatal period. Our sample included 142 pregnant veterans from 15 Veterans Health Administration (VA) medical facilities with Edinburgh Postnatal Depression Scale (EPDS) scores ≥10. Sociodemographic characteristics, military service, health utilization, and pregnancy related factors were collected as part of a telephone survey. A majority of our sample (70%) had 1 or more mental health visits or antidepressant prescriptions during pregnancy. Women with a history of depression had more mental health visits and a higher percentage of antidepressant use before and during pregnancy than women without a history of depression. Pregnant women veterans without a history of depression may be less likely to receive care for depression during pregnancy. However, the majority of our veterans showing depression symptoms prenatally had at least one mental health visit or an antidepressant medication fill during their pregnancy window, suggesting that mental health care is readily available for women veterans.

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Acknowledgements

This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development (HSR&D IIR13-81). All authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. The views expressed in this article are those of the authors and do not reflect the position or policy of the Department of Veterans Affairs or the United States Government. The authors thank Laurel A. Copeland, PhD, for her assistance with the analysis.

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Authors and Affiliations

  1. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA

    Aimee R. Kroll-Desrosiers, Tiffany A. Moore Simas, Melissa A. Clark & Kristin M. Mattocks

  2. Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA, USA

    Sybil L. Crawford

  3. Department of Obstetrics & Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, USA

    Tiffany A. Moore Simas

  4. Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA

    Tiffany A. Moore Simas

  5. Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA

    Tiffany A. Moore Simas

  6. Research and Development, VA Central Western Massachusetts, Leeds, MA, USA

    Aimee R. Kroll-Desrosiers & Kristin M. Mattocks

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  1. Aimee R. Kroll-Desrosiers
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Corresponding author

Correspondence to Aimee R. Kroll-Desrosiers.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Conflict of Interest

Dr. Moore Simas receives grant funding from the National Institute of Health (R41 MH113381) and the Centers for Disease Control and Prevention (U01DP006093) for projects related to perinatal depression. Dr. Moore Simas receives a stipend from the Massachusetts Department of Mental Health via Beacon for her role as Engagement Director of the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms). Dr. Moore Simas is Medical Director of Lifeline4Moms; she co-directs the American College of Obstetricians and Gynecologists’ Expert Work Group on Maternal Mental Health and was a member of the Council on Patient Safety in Women’s Health Care’s task force for creation of the maternal mental health patient safety bundle and co-author on the associated commentary. Dr. Moore Simas has served on ad hoc Physician Advisory Boards for Sage Therapeutics, has received speaking honoraria, and serves as a consultant on observational studies and a systematic review. Dr. Moore Simas serves as a consultant to Ovia Health, has received compensation for reviewing a perinatal depression case for McGraw Hill, and has received speaking honoraria from Miller Medical Communications. All other authors declare that they have no conflict of interest.

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Kroll-Desrosiers, A.R., Crawford, S.L., Moore Simas, T.A. et al. Treatment and Management of Depression Symptoms in Pregnant Veterans: Varying Experiences of Mental Health Care in the Prenatal Period. Psychiatr Q 91, 475–493 (2020). https://doi.org/10.1007/s11126-019-09676-7

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