Racial/Ethnic Differences in the Correlates of Mental Health Services Use among Pregnant Women with Depressive Symptoms Jen Jen Chang 1 • Maya Tabet 1 • Keith Elder 2 • Deborah W. Kiel 3 • Louise H. Flick 1 Ó Springer Science+Business Media New York 2016 Abstract Objectives To examine correlates of lifetime mental health services (MHS) use among pregnant women reporting prenatal depressive symptoms by race/ethnicity. Methods This cross-sectional population-based study included 81,910 pregnant women with prenatal depressive symptoms using data from the Florida Healthy Start pre- natal screening program (2008–2012). Multivariable logistic regression was conducted to ascertain adjusted odds ratios and corresponding 95 % confidence intervals for racial/ethnic differences in the correlates of lifetime MHS use. Results Findings of this study revealed racial/ ethnic differences in MHS use among women with prenatal depressive symptoms, the highest rates being among non- Hispanic Whites and the lowest rates among Mexicans and other Hispanics. Most need for care factors, including ill- ness, tobacco use, and physical or emotional abuse, con- sistently predicted MHS use across racial/ethnic groups after adjusting for covariates. Adjusted associations between predisposing and enabling/restricting factors and MHS use were different for different racial/ethnic groups. Conclusions Racial/ethnic differences in MHS use were found, with pregnant Hispanic women reporting prenatal depressive symptoms being the least likely to use MHS. Our study findings have significant public health implica- tions for targeted intervention for pregnant women with prenatal depressive symptoms. Keywords Maternal depression Á Mental health utilization Á Pregnant women Á Racial disparity Significance What is already known on this subject? About 1 in 5 pregnant women in the US have prenatal depression. If untreated, prenatal depression is associated with poor maternal and fetal outcomes. Yet, the mental health needs of pregnant women remain largely unmet, particularly among racial/ethnic minorities. What this study adds? Among pregnant women reporting prenatal depressive symptoms in Florida, non- Hispanic White women were the most likely and His- panics were the least likely to use mental health services (MHS). Racial/ethnic differences were observed in pre- disposing and enabling/restricting factors predicting life- time MHS utilization. This may reflect race/ethnicity- specific barriers and emphasize the need for culturally- sensitive MHS. Introduction Approximately 20 million adults experience depression each year, and women are more than twice as likely as men to be affected [30]. While depression may develop at any point in a woman’s life, the childbearing years are marked by the highest rates [25]. This may be due to & Jen Jen Chang jjchang@slu.edu 1 Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Ave., Suite 300, St. Louis, MO 63104, USA 2 Department of Health Management and Policy, Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA 3 Nursing and Allied Health Center, Lindenwood University, St. Charles, MO, USA 123 Matern Child Health J DOI 10.1007/s10995-016-2005-1