Seeking Help for Postpartum Depression: The Behavioral Model of Health Service Use as a framework for predicting Treatment Utilization for Postpartum Depressionedit
Postpartum depression is a serious disorder that affects many women globally, as well as their children and entire families. Although various treatment methods for postpartum depression have been found to be helpful, very few women actually utilize these treatments. The Jewish Israeli ultra-orthodox community (48.5% of the sample) is known for its utmost under-utilization of mental health services, therefore putting the ultraorthodox postpartum depressed women at high risk for going untreated. The reasons for the under-utilization of treatment for postpartum depression are unclear, and deserve a close investigation. The Behavioral Model of Health Service Use was used as a comprehensive framework for predicting and explaining seeking help for postpartum depression. One thousand and fifty nine (1059) women who were recruited from a large hospital in Jerusalem, Israel one to two days postpartum completed the baseline survey; 805 (76%) of them participated at the 6-week follow up, of which 12% (N= 94) screened positive for postpartum depression symptoms and were referred for help. Of the 88 referred for help, 69% utilized some sort of help (34% utilized professional help and 90% utilized nonprofessional help); 31% of the women did not utilize any form of help. Predictors of screening positive for postpartum depression at the 6-week follow-up included being older, having fewer previous pregnancies, a lower income, and a history of depression. Levels of postpartum depression symptomatology significantly decreased from 6-weeks to 6-months postpartum, overall. Utilization of non-professional help and lower postpartum depression symptomatology at 6-weeks postpartum predicted lower depression symptoms at the 6-month follow-up. Finally, confidence in mental health professionals and higher level of postpartum depression symptomatology predicted utilization of professional help. Several implications for future research, theory building and social work practice are provided.