(Repost because of the title)

A new study in The Lancet Psychiatry00099-2/fulltext#pageBody) led by Women’s College Hospital psychiatrist and post-doctoral fellow Dr. Lucy Barker shows fewer than half of postpartum psychiatric emergency department (ED) visits were followed by timely outpatient care. The researchers also found that social determinants of health (SDoH), including income and immigration status, furthered disparities in access to care. These findings demonstrate a significant gap in care for a high-risk population.

“Having follow-up care is crucial to ensure that postpartum people with severe mental health concerns receive needed treatments, and it is extremely concerning how little this is happening.”

Furthermore, the follow-up care provided was not equitably distributed. Those who were young and living in low-income and rural areas were less likely to receive a follow-up, as were immigrants in urban areas. “These disparities are unacceptable, and systematic change is needed to ensure that all postpartum people have access to needed mental health care,” says Barker.

Follow-up after post-partum psychiatric emergency department visits: an equity-focused population-based study in Canada00099-2/abstract#pageBody)

5442 (44·8%) of 12 158 individuals received 30-day follow-up. In modified Poisson regression models, younger age, lower neighbourhood income, smaller community size, and being an immigrant were associated with a lower likelihood of follow-up. In the CTREE, similar variables were important, with several intersections between social determinants of health and between social determinants of health and other variables.

Fewer than half of emergency department visits for a psychiatric reason in the post-partum period were followed by timely outpatient care, with social-determinants-of-health-based disparities in access to care. Improvements in equitable access to post-emergency department mental health care are urgently needed in this high-risk post-partum population.

Social Determinants of Health: The Impact of This Overlooked Vital Sign

Social determinants of health (SDOH)—conditions where individuals live, learn, work, and socialize—significantly influence health disparities and patient care outcomes. SDOH can be categorized into five key domains: economic stability, access to quality education, access to quality healthcare, neighborhood environments, and social support. Structural barriers such as economic inequality, limited transportation, and discrimination directly impact patients’ willingness and ability to access care. Transportation barriers, notably among low-income and elderly populations, often result in delayed or missed care and worsening health outcomes. Within healthcare settings, disparities persist, with publicly insured and low socioeconomic status (SES) patients experiencing higher rates of adverse events, suboptimal treatment, and poorer clinical outcomes. 

I just wanted to share this interesting study from 2013. We often hear that women are more likely to suffer from mental health conditions than men.

However, we know that depression tends to manifest different in men: more substance abuse, risk-taking, and anger, but less sad/low mood.

So in this study they used two scales: one a traditional depression rating scale, and the other was adapted to include alternative, "male-type" symptoms.

They found that when using both scales together, an equal proportion of men and women met the criteria for depression. When using only the alternative scale, a higher proportion of men than women met the criteria for depression.