Integrating Mental Health Screening in Reproductive Health Care: Associations between Symptoms of Depression and Anxiety, Contraceptive Method Choice, and STI Diagnosis

APHA Scientific Session and Event Listing

3279.0: Monday, November 05, 2007 - Board 9

Abstract #151524

Samantha Garbers, MPA¹, Natalie Tobier, MPH, LMSW², Sarah Blust, MPH, LMSW², Kathryn Miller, MS², and Mary Ann Chiasson, DrPH¹. (1) Research and Evaluation, Medical and Health Research Association of New York City, Inc., 40 Worth Street, Suite 720, New York, NY 10013, 212-285-0220, sgarbers@mhra.org, (2) Clinical & Community Health Programs, MHRA, 220 Church Street, 5th Floor, New York, NY 10013

A project integrating routine, standardized mental health and behavioral risk factor (BRF) screening of patients at eight reproductive health centers has included research and evaluation efforts to identify links between mental health and reproductive and sexual health. An analysis of data from all new prenatal and family planning patients BRF-screened from January 2005 - June 2006 included results from routine STI screening (Chlamydia and Gonorrhea) (new prenatal and family patients, n=6,627) and contraceptive method choice after counseling (new family planning patients only, n=3,053). Among patients studied the mean age was 27, 65% were Latina, 61% were foreign-born representing 68 countries of birth, and 67% had at least one live birth. While the number of STIs diagnosed through routine screening was low, patients who screened positive for anxiety (8% of patients) were significantly more likely to later receive a positive STI diagnosis (OR=1.6; 95%CI:1.2-2.1). Excluding patients who were seeking pregnancy, reported infertility or sterilization, or who were missing data on method choice, most family planning patients (84%) were provided a method of contraception at the end of the visit. Patients who screened positive for depression (8.4% of patients screened with the PHQ-9) were significantly more likely to choose no method or to rely on abstinence or natural family planning (OR=1.7, 95%CI:1.2-2.4). These significant associations between mental health status and sexual health provide support for the integration of mental health screening and referral into existing services as a way to enhance reproductive health outcomes.

Learning Objectives:

Assess the strength of the association between mental health symptoms and two outcomes

Expand awareness of links between mental health and reproductive health.
Identify reasons for integrating mental health screening services into reproductive health care.

Keywords: Mental Health, Contraception

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Adolescent Programs in the US (3)

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA