- Title
- Utilisation of subsidised mental health services among childbearing women who experienced depression and/or anxiety in Australia
- Creator
- Pereira, Melissa Sherrel
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2025
- Description
- Research Doctorate - Doctor of Philosopy (PhD)
- Description
- Depression and anxiety are common mental disorders affecting women of all ages. The lifetime prevalence for depression in women is reported to be one in six, whereas the lifetime prevalence for an anxiety disorder in a 12-month period is reported to be one in five women. However, the chances of experiencing these common mental disorders are increased during pregnancy and the postpartum period for women, which is associated with complex maternal, infant and family outcomes. Despite the negative sequelae correlated with these disorders, a substantial number of women do not seek or access support. Understanding the factors associated with mental health service use for these disorders will help prioritise resource allocation and the development of interventions aimed at helping the most vulnerable women during this time. This research aimed to examine the uptake of subsidised mental health services provided in Australia under Medicare’s Better Access Scheme in a nationally representative longitudinal dataset of women comprising the Australian Longitudinal Study on Women’s Health 1973-78 cohort. These women have been followed for over 22 years since 1996, and data from eight surveys was utilised in this research. This thesis aimed to fill the gaps in the existing literature on the utilisation of mental health services by women in the preconception and perinatal periods in the Australian context and its impact on maternal mental health beyond. The first study looked at the utilisation impact of subsidised mental health services in the preconception period (a year prior to the conception of the first live-born child) on the perinatal mental health of the mother in women with a history of depression and/or anxiety. Using longitudinal survey data and administrative health service usage data, logistic regression analysis was performed. Women with a history of depression and/or anxiety who utilised these subsidised mental health services four or more times in the preconception period were twice more likely (95% CI = 1.01 – 4.06) to experience depression and/or anxiety in the perinatal period, than women who did not utilise these subsidised mental health services in the preconception period. The second study examined the factors associated with the utilisation of subsidised mental health services in women who experienced depression and/or anxiety in the perinatal period. Logistic regression analysis using longitudinal survey data and administrative health service usage data was performed. Women with a history of depression only, anxiety only, and depression and anxiety prior to conception were around three times more likely (95% CI = 1.45 – 5.23), four times more likely (95% CI = 1.30 – 12.81) and around seven times more likely (95% CI = 3.22 – 14.16) respectively to use Better Access services in the perinatal period. A subsequent study examined the effect of women’s uptake of mental health services in the perinatal period on the mental health of the mother beyond two to four years post-childbirth. Based on descriptive analysis, these findings indicate around 40% of women who utilised mental health services during the perinatal period experienced poor mental health two to four years after childbirth. Finally, a systematic review of the barriers and facilitators associated with the utilisation of mental health services by women who experienced depression and/or anxiety in the perinatal period was undertaken to better understand the uptake of the broad range of services available in the Australian context. The importance of the role of healthcare professionals in encouraging or discouraging women with regard to accessing mental health support services emerged as a key factor. Taken together, the findings from this research indicate the remitting and recurrent nature of depression and anxiety among a subgroup of women despite accessing mental health services. Women with a history of depression and/or anxiety further warrant increased support and care, particularly in the preconception period. In addition, women with first incidences of depression and/or anxiety in the perinatal period were less likely to access mental health services, warranting the need for increased education and awareness of the range of services available during this period. Moreover, the role of healthcare professionals in promoting the uptake of mental health services should be underscored. The insights from this research substantially contribute to the knowledge base on mental health and associated mental health service use in women during the period of transition to motherhood. These findings will aid in the review and optimisation of perinatal mental health and mental health service use policies, particularly at a time when Medicare’s Better Access is due to undergo reform. Depression and anxiety are complex mental illnesses, with a proportion of women experiencing a more chronic and recurrent form of these disorders. Putting in safeguards at multiple time points across the woman’s reproductive lifespan, from preconception to beyond the ‘one’ year postnatal period, can help alleviate these mental health disorders and promote recovery.
- Subject
- depression; anxiety; Medicare; MBS; Better Access Scheme; Australia; subsidised; childbearing; antenatal; postnatal; mother; baby; pregnancy; perinatal; mental health; mental health services; service utilisation; uptake
- Identifier
- http://hdl.handle.net/1959.13/1516445
- Identifier
- uon:56979
- Rights
- Copyright 2025 Melissa Sherrel Pereira
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 3 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 254 KB | Adobe Acrobat PDF | View Details Download |