Trends in postpartum mental health care before and during COVID‐19

• Published in: Health services research 2022-12, Vol.57 (6), p.1342-1347
• Main Authors: Rokicki, Slawa, Steenland, Maria W., Geiger, Caroline K., Gourevitch, Rebecca A., Chen, Lucy, Martin, Michelle W., Cohen, Jessica L.
• Format: Article
• Language: English
• Subjects: Bipolar Disorder; Care and treatment; Charges; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; COVID‐19 research database; Drug abuse; Extraction; Female; Hospitalization; Humans; interrupted time series; Medicaid; Medical screening; Mental disorders; Mental Health; Mental health care; Mental health services; National health insurance; Pandemics; Perinatal; perinatal depression; Postpartum; Postpartum Period; Pregnancy; Prescription drugs; Psychological aspects; Psychotherapy; Puerperium; Research Brief; Schizophrenia; Tests; Time series; Tracks (paths); Trends
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.14051

Objective To assess the impact of COVID‐19 on trends in postpartum mental health diagnoses and utilization of psychotherapy and prescription drug treatment. Data Sources Data were obtained from a large, national health insurance claims database that tracks individuals longitudinally. Study Design We used interrupted time series models to examine changes in trends of postpartum mental health diagnoses before and during the COVID‐19 pandemic and t‐tests to examine differences in treatment. Data Extraction Methods We used billing codes to identify individuals who received mental health‐related diagnoses and treatment in the first 90 days after a birth hospitalization. We excluded individuals diagnosed with schizophrenia or bipolar disorder and those with an unknown payer at delivery. Principal Findings Compared to the pre‐pandemic period, the trend in new postpartum mental health diagnoses increased significantly in the post‐COVID‐19 period (0.06 percentage points [95%CI 0.01, 0.11]). Over 12 months, the percentage of new diagnoses was 5.0% greater relative to what would be expected in absence of COVID‐19. The percentage of diagnosed individuals who did not receive treatment increased from 50.4% to 52.7% (p = 0.003). Conclusions Findings point to an urgent need to improve screening and treatment pathways for perinatal individuals in the wake of COVID‐19.