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A new study published in PubMed looked at the case for screening and evidence-based intervention in pregnant Black people to detect depression, anxiety, and stress.

“As part of a larger randomized clinical trial to determine whether a newly created cognitive-behavioral skills building intervention is effective in improving the mental health of pregnant people of color, we screened Black pregnant women for anxiety, depression, and stress,” study author Susan Gennaro RN, PhD, FAAN told us. “In this published study, we were interested in finding out how frequently these conditions occurred and how often they occurred together.”

Other studies have shown that levels of anxiety, depression, and stress were high, but there wasn’t information about the co-occurance of these mental health concerns. New guidelines call for screening of pregnant people (e.g. anxiety and stress) but screening does not always occur and, when it does occur, treatment is not always readily available.

“We were interested in seeing how frequently these conditions occurred and how often more than one condition was experienced,” Gennaro told us. “This is fundamental information needed to plan effective interventions as part of mental health care.”

The researchers used valid and reliable tools that could be answered in a short period of time and had low reading levels such that the results found were valid and reliable. They collected data in three different health sites so that we had generalizable findings.

Black pregnant individuals experienced high levels of comorbid mental health distress including depression, anxiety and stress. Slightly less than half the participants who screened positive experienced two of these conditions reporting being depressed and stressed; 15 being anxious and stressed and seven being depressed and anxious. Notably, 64 reported being depressed, anxious, and stressed.

“We were surprised that 43.1% of the 452 Black pregnant individuals we screened had elevated psychological symptoms,” Gennaro told us. “We were surprised at how many participants experienced multiple mental health symptoms (stress, plus depression, plus anxiety).”

Gennaro believes it is important to screen for stress as well as anxiety and depression and it is imperative to screen for all conditions such that an appropriate resource is available for treatment.

“Mental health is not adequately addressed in the US,” Gennaro told us. “The mental health of the mother has a great impact on the mental health of the infant. Screening and then developing culturally appropriate and readily accessible treatment modalities is an important next step for health care in the U.S.”

Cognitive-behavioral therapy is an established evidence-based treatment for anxiety, depression and stress, yet few people receive it because of the severe shortage of mental health providers throughout the country. The research team’s larger randomized clinical trial is using advanced practice nurses instead of psychiatric mental health providers to deliver a cognitive-behavioral skills building intervention to emotionally distressed pregnant people of color. If found to be effective in reducing depression, anxiety and stress, it could be a promising solution for improve mental health care for pregnant people of color.