Mental health benefit uptake of women before and during the perinatal period in Austria

Abstract One in five women may experience a perinatal mental illness (PMI) during pregnancy and up to one year after giving birth, during the so-called perinatal period. Although there is strong evidence that this can have a negative effect on the children’s future health, many mothers do not receive any treatment. To determine whether and what type of mental health services women in Austria claim during the perinatal period, the uptake of five key mental health insurance benefits was analysed using pseudonymised health insurance data from Austria’s largest insurance, ÖGK. In 2017 and 2018, 131,025 ÖGK insured women gave birth, representing 80% of all births in Austria in the two years. Of these women, almost 20% claimed at least one benefit during the perinatal period. Including the year before pregnancy this number increased to 25%. Most often, only one benefit was claimed in only one of the analysed periods (the year before pregnancy, pregnancy, and the year after birth). Psychotherapy was claimed most often, while hospital admissions occurred the least. Further, the youngest (≤ 20 years) and the oldest (≥ 41 years) women claimed benefits more frequently than at other ages. After adjustment for the shorter pregnancy period, benefit uptake was generally highest during pregnancy and lowest after giving birth. Considering the shortage of specialised perinatal mental health services in Austria, the uptake of the five analysed types of services was high and corresponds to international prevalence figures on PMI. The actual number may be even higher, considering the services and the women not covered in the available data. As there is a lack of a perinatal mental health infrastructure and specialised healthcare staff in Austria, this warrants further investigations into the quality of care provided to the women and more training and education concerning mental problems occurring during the perinatal period. Key messages • Around a quarter of women claim mental health benefits during the perinatal period, most often psychotherapy services. • Substantial demand for mental health services during the perinatal period calls for comprehensive infrastructure and quality assessments of available options.