Self-recognition of and provider response to maternal depressive symptoms in low-income Hispanic women

Background: One quarter of mothers of young children experience high levels of depressive symptoms, and only half are identified by themselves or their providers. Little is known about what factors influence maternal and provider recognition of depression. We use data from the San Mateo County, California, Prenatal to Three project to explore self-recognition, provider response, and referral among low-income Hispanic mothers of infants and toddlers. The goals are ( 1) to describe the patterns of self-recognition of maternal depression, maternal reporting of health professional response, and referrals for mental health services as related to depression severity and ( 2) to identify determinants of self-recognition, provider response, and mental health referrals. Methods: Our sample consists of 218 nonpregnant Hispanic mothers in San Mateo County. Self-recognition was defined as an affirmative answer to the question, "Have you thought that you needed help with sadness or depression since your child was born?" High depressive symptoms were defined as a score of >= 10 on the Edinburgh Postnatal Depression Scale (EPDS). We performed chi-square and logistic regression analyses. Results: Twenty-eight percent responded that they needed help with depression since the birth of their baby. Less than half discussed depressive feelings with their provider. Depression recognition factors differed between mothers and health professionals. Conclusions: Maternal depression is prevalent among Hispanic women on Medicaid but is not readily detected by women or providers. Women and providers use different cues to identify depression, possibly leading to communication discrepancies. Further research on the factors that influence self-recognition and provider recognition of maternal depression is needed.