TABLE 5.

Barriers That Limited Pediatricians’ Ability to Diagnose or Intervene in the Last Recalled Case of Maternal or Postpartum Depression (n = 391)

Limited Somewhat or a Great Deal
Organizational barriers
 Inadequate time to provide counseling/education73%
 Appointment time too short for adequate history70%
 Mother’s insurance limited treatment options29%
 Mental health professionals not affordable28%
 Unavailability of mental health resources20%
 Difficult paperwork/authorization procedures18%
 Poor reimbursement for treatment14%
 Physician financial disincentives for mental health referrals7%
Physician barriers
 Incomplete training to diagnose/counsel64%
 Incomplete knowledge of treatment for depression48%
 Incomplete knowledge of DSM-IV diagnostic criteria44%
 Lack of effective treatments19%
Maternal and patient barriers
 Medical problems of the child were more pressing37%
 Symptoms explained by other medical illness26%
 Mother reluctant to accept diagnosis25%
 Mother reluctant to see mental health professional23%
 Mother reluctant to begin antidepressant medication15%
  • DSM-IV indicates Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.