Session: Mental Health Can't Wait: Increasing Access to Perinatal Depression Treatment Among Rural WIC Clients (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Perinatal depression impacts between 10-15% of people during pregnancy and in the 12-months after giving birth in the U.S. Perinatal people living in rural areas experience depression at higher rates than non-rural peers, yet are less likely to have access to screening or treatment. As many as 50% of PND cases go undetected and only about one-third of adults with depression ever receive treatment. Barriers to PND screening and treatment are exacerbated in rural areas due to a shortage of health and mental health providers and accessibility challenges related to cost and transportation. Further, even if treatment is available, perinatal people in rural areas often find it unacceptable, as a result of mental health stigma, fear of child protective service involvement, and lack of anonymity. Perinatal people in rural areas prefer informal systems of care, often seeking help from friends, family, and de facto mental health providers, such as clergy. This treatment access disparity presents a social justice issue that must be addressed. Social workers are well positioned to collaborate with local community-based providers in rural areas to build capacity for initiating PND screening and treatment in non-stigmatizing settings where people naturally go for services during the perinatal period.

This symposium presents an innovative community-university partnership between social work researchers and a rural Michigan Special Supplemental Nutrition Program for Women, Infants, and Children program (WIC) focused on increasing access to perinatal depression (PND) screening and treatment among low-income rural people who are pregnant or postpartum. Low-income pregnant and postpartum people, who are at increased risk for PND, often seek WIC services during pregnancy and the postpartum period. This community-university partnership began with rural WIC programs indicating their interest in enhancing support for perinatal clients who commonly reported having depressive symptoms. However, the WIC program was not formally screening clients for PND and the limited number of local mental health providers made treatment referrals difficult. Therefore, researchers and WIC providers partnered to implement PND screening and treatment within one rural clinic. The presentations in this symposium describe: 1) the outcomes of initiating PND screening as part of the standard WIC appointment, 2) a quantitative outcome evaluation of a free, technology-assisted, entertaining, cognitive behavioral-based PND treatment provided to perinatal WIC clients who screened positive for depression, and 3) a qualitative exploration of perinatal WIC clients’ experiences with PND treatment offered via the WIC program.

The lack of available mental health services in the rural U.S. has been largely ignored. The symposium discussant will connect these presentations to the Social Work Grand Challenge related to closing the health gap, with attention to strategies for building capacity to address mental health needs in rural areas and among low-income perinatal people. The discussant will also address the potential to offer mental health treatment within community-based settings where individuals with or at risk for mental health needs naturally go for services, focusing on opportunities to build and strengthen systems of care and directions for future research.