Barriers to Access to Mental Health Services in Pregnant Women With Mental Pathology Residing in Colombia

Abstract

Introduction

Pregnancy is associated with multiple physiological changes. Anxiety, depression, suicide, and consumption of psychoactive substances during gestation have been phenomena rarely studied by Colombian academia. These disorders are among the principal causes of maternal morbidity–mortality; however, the presence of barriers to care constitutes a public health problem that must be studied.

Method

A prospective longitudinal observational descriptive study was conducted, during one year, with 166 pregnant women. The prevalence of these diseases was evaluated and the most significant supply and demand barriers were identified, for which a battery of mental health measurement instruments was applied to identify the risk of consuming psychoactive substances, depression, and anxiety.

Results

The most-frequent mental pathology was gestational depression, occurring in 57.22% of the sample; the second most-frequent pathology was gestational anxiety, diagnosed in 46.98% of the patients. The disorder due to consumption of most-frequent substances was smoking; followed by cannabis and alcohol. Access barriers, both in supply and demand, were present in most of the population; 53.01% of the pregnant women were not evaluated by psychology. The principal supply barrier was not assigning appointments or, failing that, these were assigned for a very distant date.

Conclusions

A clear relationship exists among depression and anxiety, number of children and age, and supply barriers and access to specialized mental health care. Our findings suggest a high frequency of access barriers in the gestating population with mental pathology.