Women’s Help-seeking Behavior And Related Factors For Perinatal Mental Illness

[Purpose]Perinatal mental illness refers to mental illness that are prevalent during pregnancy and within one year after delivery.Anxiety and depression are the most common type.It is not only increasing the risk of gestational hypertension and diabetes but also the leading cause of maternal death.Moreover,it can also cause premature birth,low birth weight,stunted,delays in children’s intellectual and language development,cognitive deficits and so on.All of these cause great social harm.The magnitude of this harm results from the fact that people do not seek formal professional treatment in time.Perinatal women have high risk of mental illness but low rate of help-seeking,and the related research is insufficient.Therefore,it is necessary to explore help-seeking behavior and related factors of perinatal women to promote the active treatment for their mental illness.This study aimed to:(1)describe the present situation of mental help-seeking behavior for perinatal women;(2)investigate the influencing factors of mental help-seeking behavior of perinatal women;(3)establish multiple linear regression and structural equation model of influencing factors to analyze their interaction paths.[Methods]Data were collected by way of a questionnaire from a convenience sample of women recruited from the two hospital and two community health center in Wuhan.The questionnaire primarily contains:mental health condition,mental help-seeking behavior,mental help-seeking intention,mental help-seeking attitude,social support,Ehealth literacy,self-efficacy for mental help-seeking,perceived barriers,perceived benefits,perceived susceptibility and so on.They were tested by Edinburgh Postnatal Depression Scale(Cronbach’s α=0.80),Hospital Anxiety and Depression Scale-Anxiety subscale(Cronbach’s α=0.73),Actual Help-Seeking Questionnaire(Cronbach’s α=0.71),General Help-Seeking Questionnaire(Cronbach’s α=0.70),Attitude toward seeking professional psychological help scale-short form(Cronbach’s α=0.82),Multidimensional Scale of Perceived Social Support(Cronbach’s α=0.95),Ehealth Literacy Scale(Cronbach’sα=0.95),The Self-Efficacy for Seeking Mental Health Care scale(Cronbach’s α=0.95),Help-seeking barrier scale(Cronbach’s α=0.85),Benefit subscale of Disclosure Expectations Scale(Cronbach’s α=0.81),and Susceptibility subscale of Health Beliefs about Mental Illness instrument(Cronbach’s α=0.90).Data was analyzed by means of descriptive statistics,Chi-square test,Mann Whitney U test,Kruskal Wallis H test,Pearson’s and Spearman’s correlation,stepwise multiple linear regression,and structural equation model.[Results]A total of 513 perinatal women were enrolled in this study,with an average age of 30.46±4.07 years.It consisted of 309 pregnant women with average gestational weeks of 34.61±3.59 weeks and 204 pregnant women with average postpartum months of 5.57±3.06 months.259(50.5%)of them suffered from perinatal mental illness(anxiety or depression).Among the women with perinatal mental illness,161(62.2%)of them were aware of that they could have mental illness and 140(54.1%)of them had help-seeking behavior,while 139(53.7%)of them had sought the informal help and 113(43.6%)of them had the intention to seek formal help,but only 14(5.4%)people had the professional help.Moreover,119(45.9%)people had not sought any form of help.The results of univariate analysis and stepwise multiple linear regression showed that better conjugal relationship could lead to the increased informal help-seeking intention and lower degree of anxiety and depression of perinatal women(P<0.05),while their behaviors of seeking help from partner would not change(P>0.05)but those from parents or friends would decreased(P<0.05).Then better conjugal relationship leaded to less informal help-seeking behaviors(P<0.05).In addition,increased informal help-seeking behaviors ware associated with higher social support(P<0.05),higher degree of anxiety and depression(P<0.05)and stronger informal help-seeking intention(P<0.05).Formal help-seeking behavior of pregnant women was significantly higher than that of postpartum women(P<0.05).Enhanced formal help-seeking intention(P<0.05)and increased informal help-seeking behavior(P<0.05)would promote the formal help-seeking behavior of perinatal women.In result of structural equation model,help-seeking barrier(0.016)and perceived susceptibility(0.050)would indirectly influence informal help-seeking behavior of perinatal women.The formal help-seeking behaviors of perinatal women were be indirectly affected by help-seeking attitude(0.034),social support(0.011),Ehealth literacy(0.012),help-seeking self-efficacy(0.030),perceived help-seeking benefits(0.008)and susceptibility(0.010),depression(0.045)and anxiety(0.020).[Conclusions]Perinatal mental illness has high incidence.In term of help-seeking,women with perinatal mental illness prefer informal help-seeking compared to the formal one.Contrast to the rate of formal help-seeking for perinatal mental illness from other developed and developing countries,the rate of formal help-seeking of Chinese perinatal women is lower,which is also lower than the average help-seeking rate of psychological diseases in China.In addition,there still are lots of women do not take any form of help-seeking behavior for perinatal mental illness.Furthermore,informal help-seeking behaviors have an important positive impact on formal help-seeking behaviors.As spouses are the important mental help-seeking object,good conjugal relationship can also prevent the occurrence and deterioration of perinatal mental illness.Compared with pregnant women,formal help seeking behavior of postpartum women is significantly reduced.The help-seeking intention of perinatal women is the predictor of their help-seeking behavior,and their intention is positively related with their behavior.Positive attitude can indirectly promote the formal help seeking behavior.The improvement of social support can promote informal help-seeking behavior of perinatal women,and then indirectly promote their formal help-seeking behavior.The enhancement of Ehealth literacy and help-seeking self-efficacy of perinatal women can indirectly promote their formal help seeking behavior.Perinatal women will turn to adopt informal help-seeking behaviors when they perceived increased barriers.The more benefits perinatal women perceive,the more formal help-seeking behaviors they will have.And the higher susceptibility perinatal women perceive,the more their informal help-seeking behaviors will have,which also indirectly promoting their professional help-seeking behavior.When the degree of anxiety and depression is mild,few perinatal women seek help,and they will delay to seek help until the condition is serious.