This presentation features the 2016 Lutterman Award Winner For Best Student Paper: Betty Shannon Prevatt. Purpose: Postpartum mood disorders (PPMD) represent a serious mental health concern affecting 10-20% of mothers. Consequently, the US Preventive Task Force called for universal screening of perinatal women to improve PPMD identification and treatment. However, questions remain regarding how to promote disclosure and help-seeking. The present study examined: 1) patterns of PPMD symptom disclosure to healthcare providers, 2) perceived supportiveness of new mothers' healthcare and social networks, and 3) perceived barriers to treatment. methods: A community sample of women (n=235) who had delivered a child since January 1, 2013 were recruited to participate in an online survey that queried their postpartum experiences of PPMD disclosure and care, as well as clinical and sociodemographic characteristics. findings: Overall, 52.8% (n=124) of the sample reported experiencing PPMD symptoms. Women were most likely to be screened by and to disclose to their OBGYN (63.0% and 52.6%), followed by their infant's pediatrician (55.1% and 35.5%), and OBGYN staff (30.8% and 16.2%). However, only half (n=63) of those who reported PPMD symptoms indicated that they were ever formally diagnosed. Nonetheless, women were significantly more likely to rate their providers as attentive than dismissive of their symptoms across healthcare professions (ps <.001), with the exception of primary care physician and PCP staff (ps>.183). Participants ranked the support of their partner/spouse, family, and friends as the most important contributors to their postpartum adjustment (p<.001). Despite this support, almost half of women (46.9%) reported at least one barrier that made seeking treatment “impossible” or “extremely difficult”. Stigma (18.6%), time constraints (18.6%), and cost (14.9%) were the most frequently endorsed treatment barriers. implications: Many women experiencing clinically-significant levels of distress were not screened for PPMD symptoms and, consequently, did not disclose their symptoms or receive appropriate care. Findings suggest that interventions designed to improve PPMD disclosure and promote help-seeking could build upon the perceived supportiveness of women's social networks, OBGYNs, and pediatricians. Additionally, continued efforts are needed to reduce the stigma, time constraints, and costs that act as barriers to PPMD treatment.

PURPOSE Perinatal depression can result in adverse maternal and child health outcomes. For high-risk pregnancies, like gestational diabetes (GDM) or obesity, behavior changes are advised, but can be challenging to achieve with mental health stressors or depression. The U.S. Preventative Services Task Force (USPSTF) issued an ‘A' recommendation to screen adults for depression, highlighting perinatal women. Low-income women with high-risk pregnancies are at elevated risk for a constellation of vulnerability factors to mental health stressors. We conducted a cross-sectional study to characterize the prevalence of socio-demographic risk factors for mental health stressors and depression. METHODS As part of a pilot trial examining the impact of a narrative-based bilingual (English/Spanish) health IT intervention combining automated telephone calls with health coach call backs (STAR MAMA) on diabetes risk among postpartum, primarily GDM Latina women ages 18-35 years, we conducted baseline interviews with pregnant and postpartum women(<5 weeks). Assessments included: socio-demographics, diabetes risk, migration, social support, food insecurity and self-reported mental health outcomes (PHQ-2 and SF-8 Health Survey). Working with safety net clinics and Women, Infants and Children's Programs(WIC) in San Francisco and Sonoma counties, we enrolled eligible women through clinic-based recruitment. FINDINGS Over 90 women are enrolled (half of sample), with data presented on 53 women. Participants accounted for a high percentage (93%) of clinic attendees. Most (93%) women had GDM, and the remainder had BMIs over 25. Over 75% were Latina, born outside the USA, and are primarily Spanish-speaking (64%). Education levels were low; 77% had a high school diploma or less, 65% reported annual household income below $20,000, and almost 20% reported food insecurity. Regarding mental health, 8% reported being told they were depressed by a doctor, 40% reported emotional problems, and 20% reported having no social support. IMPLICATIONS Little is known about mental health risk factors among high-risk pregnancies in the safety net. These estimates support that they are substantial. Health care providers should take the USPSTF's recommendation seriously for this population. Due to mental health treatment stigma, especially among diverse populations, screening, culturally-relevant health care and support are recommended. Understanding implementation in clinical and community settings is critical.

Purpose: Access to quality health care is vital for children and youth with mental illness. Without comprehensive health care coverage, case management and care coordination, children and youth with mental illness may experience fragmented and poor access to care, little to no engagement in care, and poor retention in care. To date, little is known about factors that influence patient and family engagement and retention in mental health care among Black/African American, Latino, and White children and youth with mental illness. This study examined how individual and contextual factors influence patient and family engagement and retention in mental health care from the caregiver's or parent's perspective. Methods: Qualitative interviews were conducted with Black/African American, Latino, and White parents and caregivers (n=20) of children and youth who had received mental health services. Data were analyzed using NVivo 10 qualitative software to assess differences in experiences of care, and factors that influenced patient and family engagement and retention in care. Data were analyzed using thematic content analysis to understand multidimensional factors influencing health services utilization. Findings: Access to early childhood mental health services is imperative for diagnosing and treating mental illness. Poor access and coordination of care often lead to frequent emergency room utilization, hospitalizations, diminished health outcomes, poor quality of care, and eventual high health care costs. Systems of care such as early childhood intervention programs and schools are critical for the identification of mental illness in early childhood. Cross-system case management and care coordination are key strategies for reducing fragmented care, health care costs, and improving the experiences and quality of life for children and their families. Implications for policy and practice: As health care systems strive to improve the quality of care for children and their families, it is imperative to understand the experiences of parents and caregivers raising children and youth with mental illness. Recognizing individual and contextual factors and challenges that families experience and how these contribute to engagement and retention in care will inform future prevention and treatment interventions for children and youth with and or at risk for mental illness.

purpose: Latinos in the U.S. face greater barriers to accessing mental health resources than other ethnic groups. This disparity is attributed to low awareness of mental illnesses, stigma associated with mental illnesses, limited health insurance, and, for undocumented immigrants, social isolation, communication barriers, and fear of deportation. To mitigate barriers to accessing mental health resources, health promoters or Promotores de Salud Mental have emerged to provide mental health education and linkages to health resources. Health workers assert that the Promotores de Salud Mental Project Model (PPM) raises awareness about mental health and promotes help-seeking behavior. However, few quantitative studies have evaluated PPM success achieving these goals. In this study, we do three things: (1) Assess how PPM increases recognition of early signs of severe mental illnesses, (2) Evaluate how PPM encourages seeking mental health services; and,(3) Demonstrate how PPM reduces stigma associated with mental illness. methods: We conducted a randomized case control study with four hundred and twenty-one Spanish speaking Latina women from a variety of communities in Los Angeles County. 211 women had participated in a PPM and 210 had not. Measurements assessed ability to identify mental illnesses, willingness to access mental health services, and agreement with stigmatizing beliefs about mental illnesses. findings: The majority of participants, PPM and non-PPM, recognized some type of mental illness in the vignette shown: 92.4% for the depression vignette (correctly labeled as depression by 72%) and 88% for the schizophrenia vignette (correctly labeled by 12%). PPM respondents were more likely to seek mental health services than non-PPM respondents (p ≤.05), and, when asked about the woman in the vignette experiencing signs of mental illness, PPM respondents were less likely than non-PPM respondents (p ≤.05) to have stigmatizing beliefs about the woman in the vignette, on four measures: ability to snap out of it, sign of personal weakness, dangerous to others, and, tell anyone if I had this problem. implications for policy, research and practice: PPM can improve mental health indicators for Latina women by encouraging help seeking behavior, reducing stigma and proving linkages to mental health services.