Enhancing Equitable Access to Perinatal Mental Health Care: Online Screening and a Video Intervention Promoting Help-Seeking Intentions

Background and Purpose:
Perinatal depression (PND) is a prevalent and consequential public health concern, affecting approximately 10%–20% of women during pregnancy and the postpartum period. Despite the availability of effective interventions, most women experiencing PND do not seek care, resulting in adverse outcomes for mothers, infants, and families, as well as increased healthcare utilization and economic burden. While face-to-face screening has been shown to improve detection rates, implementation remains inconsistent across countries, and many women encounter structural barriers to accessing screening services. Moreover, inequities related to race, socioeconomic status, and geographic location contribute to lower screening uptake and reduced engagement with mental health care. Innovative, accessible screening and referral approaches are therefore needed to promote equitable access to care and enhance help-seeking. This study examined whether an online PND screening and referral platform, incorporating a brief help-promoting video, increases women’s intentions to utilize mental health services.

Methods:
Pregnant women and women up to six months postpartum were recruited via social media and randomly assigned to either a video condition or a control condition. Participants in the intervention group viewed a brief video explaining PND and encouraging mental health service utilization, while those in the control group did not. All participants completed measures assessing depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS]), prior mental health treatment experience, and intentions to seek mental health care if needed.

Results:
Among the 690 women who participated in the study, 33% had depressive symptoms. Participants exposed to the help-promoting video reported significantly higher intentions to seek mental health care (M=2.58, SD=1.35) compared to those in the control condition (M=2.26, SD=1.33). Regression analyses revealed a significant three-way interaction between video exposure, level of depressive symptoms (EPDS scores), and prior mental health treatment. Simple slopes analyses indicated that among participants with prior treatment experience, exposure to the video was associated with higher help-seeking intentions regardless of current symptom severity (all p<.05). In contrast, among participants without prior treatment experience, the effect of the video was moderated by symptom level: exposure increased intentions when EPDS scores were low (β=.35, p=.002), but had no significant effect at average (β=.14, p=.07) or high (β=-.05, p=.65) levels of depressive symptoms.

Conclusions and Implications:
Findings suggest that online screening and referral platforms incorporating a brief, help-promoting video intervention can enhance help-seeking intentions and represent a scalable strategy for expanding access to perinatal mental health care. However, women with elevated depressive symptoms and no prior treatment experience may require more intensive or tailored engagement strategies. By lowering barriers to screening and supporting early identification, such approaches can contribute to more inclusive and equitable mental health care systems. These findings underscore the importance of diversifying screening modalities to reach underserved populations and strengthen pathways to care. Integrating accessible, technology-based interventions into routine practice has the potential to promote equity, enhance participation in care, and advance the broader goal of improving population mental health for the common good.