Mental Health Challenges and Barriers to Telemedicine for Postpartum Women of Color During COVID-19: Examining the Role of Communication Technology

Abstract

This research examines mental health in postpartum women of color (WOC) during COVID-19 including risk for development of postpartum depression (PPD). Barriers and challenges to PPD treatment via telemedicine are also assessed using the Technology Acceptance Model (TAM) as a guiding framework. During the summer of 2020, 135 participants identifying as WOC in the postpartum period completed an online survey. Survey measures administered include the Edinburgh Postnatal Depression Scale (EPDS); the eHealth Literacy (eHEALS) scale; and items assessing preference for in-person vs. digital psychotherapy. Open-ended questions were used to further assess mental health challenges and opinions of virtual therapy. The average reported EPDS score was 11.4; a score >9 is indicative of PPD. However, only 26% of participants reported receiving mental health services. Of this 26%, only 11% used telemedicine for virtual therapy. Factors reported by participants as negatively impacting their mental health during COVID-19 include social support challenges, increased domestic duties, financial challenges, and health-related concerns. Participants reported high confidence in using technology to access health information; the average eHEALS score was 32.5. Reported connectivity was also high, with 98.5% owning a smartphone and 86% having access to Wi-Fi. A majority (84%) of participants were open to therapy while 76% were open to virtual therapy. Barriers to virtual therapy include cost, time, and trust. While reporting the technology, digital health literacy, and openness to participating in virtual therapy, few postpartum WOC have spoken to a mental health professional; even fewer have done so virtually. More work is needed to make virtual therapy more accessible.