Postpartum Help Seeking: The Role of Mental Health Literacy and Stigma

Background: Postpartum depression (PPD) is the most common complication associated with childbirth, affecting 10-15% of new mothers. PPD is characterized by debilitating symptoms including sadness, hopelessness, thoughts of self-harm, decreased self-esteem, feelings of failures, and disturbances in sleep and eating patterns. PPD can manifest as early as four weeks postpartum and as late as 12 months postpartum. Left untreated, PPD poses significant health risks to mothers and infants. Women suffering from PPD experience lower quality of life and decreased ability to care for themselves, their children, and families. PPD increases the risk of distress in attachment between mother and child which can lead to impaired social, emotional, and cognitive development for the offspring. More extreme consequences include maternal suicide and infanticide.

While it’s the most common complication associated with childbirth, PPD is also the most underrecognized. In spite of having frequent contact with health providers, many women who suffer postpartum depression remain undetected and untreated. One reason might relate to low rates of help seeking among women with postpartum depression, as some scholars found that less than 50% of women with PPD seek help. This study seeks to identify barriers of help-seeking among new mothers by examining mental health literacy, stigma, and attitudes.

Methods: Utilizing Facebook, participants were invited to participate in an anonymous survey (N = 188) regarding postpartum depression and help seeking behaviors. Among demographics, the Edinburgh postnatal depression scale, the Attitudes Toward Seeking Professional Psychological Help Shortened Form [ATSPPH-SF] were used to identify depressive symptoms and help seeking attitudes among participants.  

Results: Results of a mediation analysis conducted using ordinary least squares path analysis (Hayes, 2013), indicated that an increased knowledge of mental health issues  (Mental health Literacy) directly influenced attitudes toward help-seeking among postpartum women. There was no effect of mental health literacy on stigma (β= .006, t (.008) p = .99). Participants who perceived higher levels of stigma related to help seeking for postpartum depression experienced worse attitudes toward help seeking. (β= -.0001, (-.0214, .0223).  when controlling for mental health literacy. Participants with higher levels of MHL had more positive attitudes toward seeking professional help (β= .6164 , t (6.53)p = .000). There was no effect of mental health literacy on stigma indicating a mediating relationship does not exist. However, there is a direct positive relationship found between mental health literacy and attitudes and a direct negative relationship between stigma and attitudes.

Conclusion: The present study examined the way in which mental health literacy and stigma predict attitudes toward help seeking among postpartum women. This study adds empirical evidence to the current postpartum depression literature by exploring mental health literacy as a factor that affects professional psychological help seeking attitudes among new mothers – a construct that has not been studies with this population. Finally, knowledge about mental health issues directly influences help seeking attitudes. This result implies that education and accurate information about mental illness, especially postpartum depression, is a critical resource for new mothers.