The Prevalence and Factors Associated With Positive Mental Health Help-seeking Behaviour Among Pregnant Women in Klang Valley
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Abstract
Introduction: Perinatal depression and anxiety are prevalent, but professional mental health help-seeking remains low, resulting in a lack of utilization of mental health services. We aimed to determine the prevalence of positive mental health help-seeking behaviour (MHHSB) among pregnant women and its associated factors. Materials and methods: This cross-sectional study was conducted at an urban public maternal and child health clinic (MCHC) in Selangor, Klang Valley between August and November 2022. 296 pregnant women were recruited. The Malay version of Edinburgh Postnatal Depression Scale (EPDS), Self-Stigma of Seeking Psychological Help (SSOSH), Mental Health Literacy Scale (MHLS) and MHHSB questionnaires were used for data collection. Multivariate logistic regression was used to identify factors. Results: The mean age was 30.06 (±5.14) years and more than two-third (61%, n=181) were multiparous. More than half (57.4%, n=170) were in their second trimester, while 15.9% (n=47) and 21.3% (n=63) had probable depression and anxiety, respectively. The prevalence of positive MHHSB was 73.6% (95% CI: 0.68, 0.78), yet the prevalence of probable getting professional assistance was 22.6% (95% CI: 0.18, 0.28). Two factors were associated with positive MHHSB. These were probable anxiety [odds ratio (OR)3.86, 95% CI: 1.80, 9.15] and MHLS [OR 1.05, 95% CI: 1.03, 1.08]. Conclusion: Positive MHHSB was prevalent among pregnant women, yet the possibility of seeking professional assistance is low. Having anxiety was likely to influence MHHSB, hence efforts to improve mental health literacy and training staff to recognize symptoms and cultivating supportive environment for pregnant women will ensure timely interventions.
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Ceulemans M, Foulon V, Ngo E, Panchaud A, Winterfeld U, Pomar L, et al. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic-A multinational cross-sectional study. Acta Obstet Gynecol Scand. 2021.
Jha S, Salve HR, Goswami K, Sagar R, Kant S. Burden of common mental disorders among pregnant women: A systematic review. Asian J Psychiatr. 2018;36:46-53.
Mateus V, Cruz S, Costa R, Mesquita A, Christoforou A, Wilson CA, et al. Rates of depressive and anxiety symptoms in the perinatal period during the COVID-19 pandemic: Comparisons between countries and with pre-pandemic data. J Affect Disord. 2022;316:245-53.
Mohamad Yusuff AS, Tang L, Binns CW, Lee AH. Prevalence of antenatal depressive symptoms among women in Sabah, Malaysia. J Matern Fetal Neonatal Med. 2016;29(7):1170-4.
Arifin SRM, Ismail AS, Samsudin S, Hassan NA, Wan Mamat WH. Prevalence and Factors Associated with the Depressive and Anxiety Symptoms amongst Antenatal Women. International Medical Journal Malaysia. 2021;20(1):3 - 10.
Nagandla K, Nalliah S, Yin L, Majeed Z, Ismail I, Zubaidah S, et al. Prevalence and associated risk factors of depression, anxiety and stress in pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016:2380-8.
Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M. Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia. BMC Psychiatry. 2018;18(1):195.
SM. M. Depression during pregnancy: rates, risks and consequences—Motherisk update 2008. Can J Clin Pharmacol. 2009;16(1).
Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012-24.
Grigoriadis S., Graves L., Peer M., Mamisashvili L., Tomlinson G., Vigod S.N., et al. Maternal Anxiety During Pregnancy and the Association With Adverse Perinatal Outcomes: Systematic Review and Meta-Analysis. J Clin Psychiatry. 2018;79(5).
Thio IM, Oakley Browne MA, Coverdale JH, Argyle N. Postnatal depressive symptoms go largely untreated: a probability study in urban New Zealand. Soc Psychiatry Psychiatr Epidemiol. 2006;41(10):814-8.
Dennis C-L, Chung-Lee L. Postpartum Depression Help-Seeking Barriers and Maternal Treatment Preferences: A Qualitative Systematic Review. Birth. 2006;33(4):323–31.
Baldisserotto ML, Miranda Theme M, Gomez LY, Dos Reis TBQ. Barriers to Seeking and Accepting Treatment for Perinatal Depression: A Qualitative Study in Rio de Janeiro, Brazil. Community Ment Health J. 2020;56(1):99-106.
Da Costa D, Zelkowitz P, Nguyen TV, Deville-Stoetzel JB. Mental health help-seeking patterns and perceived barriers for care among nulliparous pregnant women. Arch Womens Ment Health. 2018;21(6):757-64.
Adjorlolo S. Seeking and receiving help for mental health services among pregnant women in Ghana. PLoS One. 2023;18(3):e0280496.
Doll CM, Michel C, Rosen M, Osman N, Schimmelmann BG, Schultze-Lutter F. Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study. BMC Psychiatry. 2021;21(1):432.
Cornally N, McCarthy G. Help-seeking behaviour: a concept analysis. Int J Nurs Pract. 2011;17(3):280-8.
Wang Q, Song B, Di J, Yang X, Wu A, Lau J, et al. Intentions to Seek Mental Health Services During the COVID-19 Pandemic Among Chinese Pregnant Women With Probable Depression or Anxiety: Cross-sectional, Web-Based Survey Study. JMIR Ment Health. 2021;8(2):e24162.
Fonseca A, Gorayeb R, Canavarro MC. Womens help-seeking behaviours for depressive symptoms during the perinatal period: Socio-demographic and clinical correlates and perceived barriers to seeking professional help. Midwifery. 2015;31(12):1177-85.
Bowen A, Bowen R, Butt P, Rahman K, Muhajarine N. Patterns of Depression and Treatment in Pregnant and Postpartum Women. The Canadian Journal of Psychiatry. 2012;57(3):161-7.
Recto P, Champion JD. "We Don't Want to be Judged": Perceptions about Professional Help and Attitudes Towards Help-Seeking among Pregnant and Postpartum Mexican-American Adolescents. J Pediatr Nurs. 2018;42:111-7.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782-6.
Sinesi A, Maxwell M, O'Carroll R, Cheyne H. Anxiety scales used in pregnancy: systematic review. BJPsych Open. 2019;5(1):e5.
Abdul Kadir A, Nordin R, Ismail SB, Yaacob MJ, Mustapha WMRW. Validation of the Malay version of Edinburgh Postnatal. Asia Pac J Fam Med. 2004;3.
Rushidi. WM, WM., A. A, M. MN. Revalidation of the Malay version of the Edinburgh Postnatal Depression Scale (EPDS) among Malay postpartum women attending the Bakar Bata Health Center in Alor Setar, Kedah, Northwest of Peninsular Malaysia. Malays J Med Sci. 2003;10(2):71-5.
Levis B, Negeri Z, Sun Y, Benedetti A, Thombs BD, Group DESDE. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ. 2020;371:m4022.
Smith-Nielsen J, Egmose I, Wendelboe KI, Steinmejer P, Lange T, Vaever MS. Can the Edinburgh Postnatal Depression Scale-3A be used to screen for anxiety? BMC Psychology. 2021;9(1).
Vogel DL, Wade NG, Haake S. Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology. 2006;53(3):325-37.
Ibrahim N, Amit N, Shahar S, Wee LH, Ismail R, Khairuddin R, et al. Do depression literacy, mental illness beliefs and stigma influence mental health help-seeking attitude? A cross-sectional study of secondary school and university students from B40 households in Malaysia. BMC Public Health. 2019;19(Suppl 4):544.
Siti Nor Amirah MH, Husna H, Muhamad Afnan A, Suriani I, M.N. AIN, Mal J Med Health Sci 16(1): 121-125 J. Sociodemographic Factors of Mental Health Literacy Among Housewives Living in Low Cost Apartments in Puchong, Selangor, Malaysia. Mal J Med Health Sci. 2020;16(1):121-5.
O'Connor M, Casey L, Clough B. Measuring mental health literacy--a review of scale-based measures. J Ment Health. 2014;23(4):197-204.
Lynn MR. Determination and Quantification Of Content Validity. Nursing Research. 1986;35(6):382-6.
Yusoff MSB. ABC of Response Process Validation and Face Validity Index Calculation. Education in Medicine Journal. 2019;11(3):55-61.
Conroy R. Sample size: A rough guide. Retreived from http://www beaumontethics ie/docs/application/samplesizecalculation pdf. 2015.
Daehn D, Rudolf S, Pawils S, Renneberg B. Perinatal mental health literacy: knowledge, attitudes, and help-seeking among perinatal women and the public - a systematic review. BMC Pregnancy Childbirth. 2022;22(1):574.
Kusumawati Y, Widyawati W, Dewi FST. Vulnerable to mental health problems: Pregnant women and husband's perception in Surakarta, Indonesia. Enferm Clin (Engl Ed). 2022;32(5):334-43.
Fellmeth G, Kanwar P, Sharma D, Chawla K, DasGupta N, Chhajed S, et al. Women's awareness of perinatal mental health conditions and the acceptability of being asked about mental health in two regions in India: a qualitative study. BMC Psychiatry. 2023;23(1):829.
Rickwood D, Deane FP, Wilson CJ, Ciarrochi J. Young people’s help-seeking for mental health problems. Australian e-Journal for the Advancement of Mental Health. 2005;4(3):218-51.
Gorczynski P, Sims-schouten W, Hill D, Wilson JC. Examining mental health literacy, help seeking behaviours, and mental health outcomes in UK university students. The Journal of Mental Health Training, Education and Practice. 2017;12(2):111-20.
Kutcher S, Wei Y, Coniglio C. Mental Health Literacy. The Canadian Journal of Psychiatry. 2016;61(3):154-8.
Furnham A, Swami V. Mental health literacy: A review of what it is and why it matters. International Perspectives in Psychology: Research, Practice, Consultation. 2018;7(4):240–57.
Shahwan S, Goh CMJ, Tan GTH, Ong WJ, Chong SA, Subramaniam M. Strategies to Reduce Mental Illness Stigma: Perspectives of People with Lived Experience and Caregivers. Int J Environ Res Public Health. 2022;19(3).
Sorsa MA, Kylmä J, Bondas TE. Contemplating Help-Seeking in Perinatal Psychological Distress—A Meta-Ethnography. International Journal of Environmental Research and Public Health. 2021;18(10).
Heinig I, Wittchen H-U, Knappe S. Help-Seeking Behavior and Treatment Barriers in Anxiety Disorders: Results from a Representative German Community Survey. Community Mental Health Journal. 2021;57(8):1505-17.
Pattyn E, Verhaeghe M, Sercu C, Bracke P. Public stigma and self-stigma: differential association with attitudes toward formal and informal help seeking. Psychiatr Serv. 2014;65(2):232-8.
Berry C, Michelson D, Othman E, Tan JC, Gee B, Hodgekins J, et al. Views of young people in Malaysia on mental health, help-seeking and unusual psychological experiences. Early Interv Psychiatry. 2020;14(1):115-23.
Keya T, Fernandez K, Kharkwal K, Habib N. Impact of antenatal care on pregnancy outcomes: A cross-sectional study in a rural community in Malaysia. Medical Journal of Dr DY Patil Vidyapeeth. 2021;14(2).
Spagnolo J, Champagne F, Leduc N, Rivard M, Piat M, Laporta M, et al. Mental health knowledge, attitudes, and self-efficacy among primary care physicians working in the Greater Tunis area of Tunisia. Int J Ment Health Syst. 2018;12:63.
Latha K, Meena KS, Pravitha MR, Dasgupta M, Chaturvedi SK. Effective use of social media platforms for promotion of mental health awareness. J Educ Health Promot. 2020;9:124.
Betton V, Borschmann R, Docherty M, Coleman S, Brown M, Henderson C. The role of social media in reducing stigma and discrimination. Br J Psychiatry. 2015;206(6):443-4.