Factors associated with mental health treatment among Michigan medicaid enrollees with perinatal mood and anxiety disorders, 2012–2015.

Perinatal mood and anxiety disorders (PMADs) represent the most prevalent pregnancy-related comorbidity and a leading cause of maternal mortality. Effective treatments exist, but remain underutilized. We sought to identify factors associated with receipt of prenatal and postpartum mental health treatment. This observational, cross-sectional analysis used self-reported survey data from the Michigan Pregnancy Risk Assessment Monitoring System linked to Michigan Medicaid administrative claims for births from 2012 to 2015. We used survey-weighted multinomial logistic regression to predict prescription medication and psychotherapy utilization among respondents with PMADs. Only 28.0% of respondents with prenatal PMAD and 17.9% of respondents with postpartum PMAD received both prescription medication and psychotherapy. During pregnancy, Black respondents were 0.33 (95%CI: 0.13–0.85, p = 0.022) times less likely to receive both treatments while more comorbidities were associated with receipt of both treatments (adjRR = 1.31, 95%CI: 1.02–1.70, p = 0.036). In the first three months postpartum, respondents with four or more stressors were 6.52 times more likely to receive both treatments (95%CI: 1.62–26.24, p = 0.008) and those satisfied with prenatal care were 16.25 times more likely to receive both treatments (95%CI: 3.35–78.85, p = 0.001). Race, comorbidities, and stress are critical factors in PMAD treatment. Satisfaction with perinatal healthcare may facilitate access to care. • Medicaid enrollees with PMAD were more likely to fill prescription medication than attend psychotherapy. • Black Medicaid enrollees with PMAD were less likely to fill prescription medications during pregnancy than white enrollees. • Life stressors and comorbidities increased likelihood of receiving both prescription medication and psychotherapy. • Satisfaction with prenatal care increased likelihood of attending psychotherapy. [ABSTRACT FROM AUTHOR]