Uptake of mental health benefits in women before and during the perinatal period in Austria: An analysis of health insurance data

Abstract

Abstract Background Perinatal mental illness (PMI) is one of the major health problems during pregnancy and one year after birth (perinatal period), with strong evidence of its potential detrimental (future) effects on the health of children. However, many parents do not receive treatment for their mental health problems. In Austria, there is a lack of specialised services. The amount of mental health benefits uptake during the perinatal period is unknown. Methods We retrospectively analysed the uptake of five key mental health insurance benefits, one year before and during the perinatal period, by women who gave birth in 2017 and 2018. We used pseudonymised health insurance data, applying descriptive analysis to present overall uptake frequencies, and dissecting them into three life course periods: the year before birth, the pregnancy period, and the year after birth. Results 131 025 insured women gave birth in 2017 or 2018, representing around 80% of all births in Austria. Almost 20% of women claimed at least one of the five benefits during the perinatal period; this increased to one in four women when the year before pregnancy was included. Most women claimed only one benefit, usually only during one of the three life course periods. Benefits were claimed more frequently by the youngest (≤ 20 years) and the oldest (≥ 41 years) women. After adjusting for the shorter period of pregnancy, the uptake of benefits was highest during pregnancy. The most often used benefit was psychotherapy, while hospital admissions occurred least frequently. Conclusion Although the results likely underestimate the true uptake, because more services are available than covered in our data, and service use is usually lower than the prevalence of PMI, our uptake data corresponds to international prevalence figures, indicating a high use of benefits. Considering the gaps in specialised perinatal mental healthcare infrastructure and healthcare staff, the results call for more training and education and ensuring enough capacity to meet the needs. Additionally, an in-depth investigation of the quality of care is warranted to determine whether the differences in uptake between the three life-course periods are based on unmet needs or inappropriate care.