Preferences for depression advice among low-income women

Because patient reluctance to discuss depression may influence the success of depression interventions, we assessed preferences for the source of depression advice among high-risk women and factors associated with those preferences.

The sample included 147 consecutive patients at a hospital-based obstetrics and gynecology clinic. All were age 18-44, on Medicaid and able to complete a previsit survey and postvisit interview. Women were asked "Where would you prefer to get advice on how you are feeling, whether you are sad or worried?" Responses were grouped as the ob/gyn clinic, general medical provider, mental health/substance abuse provider or no professional advice desired.

Many women did not want professional advice on depression: 33% said they preferred to get advice from informal sources and 5% preferred no information. A total of 23% of women preferred to discuss depression with the ob/gyn provider, 14% with a general medical provider, and 25% with a mental health or substance abuse provider. Women were more likely to want advice from a health provider (of any type) if they had previously use mental health care (OR = 3.6, p = 0.005) or had at least one chronic health condition (OR = 3.1, p = 0.013). Women were more likely to want advice from the ob/gyn clinic if it was their primary care provider (OR = 41.8, p = 0.002) or if they had high depressive symptoms (OR = 4.8, p = 0.048).

Many women do not want to discuss depression with a health professional, but familiarity with the mental health care system, health status, and relationship with a provider influence women's openness to depression advice.