RESUMO
PURPOSE: To assess Black women's exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms. METHODS: Data from the Black Mothers' Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15. RESULTS: The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R2 = 0.58, p = < 0.001) compared to the EPDS-3 (R2 = 0.46, p = < 0.001) or the PHQ-15 (R2 = 0.14, p = 0.035). CONCLUSIONS: Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women's postpartum mental health.
RESUMO
Background and Objectives: Suicide has become a major public health concern worldwide and in the United States. Rates of suicide increase during the life course and are highest among middle- to old-age adults. Help-seeking represents a crucial coping mechanism that can mitigate suicide risk. Yet, less is known about suicide risk help-seeking, especially among these age groups. To address this knowledge gap, a systematic review of existing literature was performed to obtain a refined understanding of help-seeking for suicide risk among middle- to old-age adults. Research Design and Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, electronic databases and key journals with suicide and/or gerontology focuses were searched to identify peer-reviewed publications in English between 2010 and 2020. A total of 4 732 unduplicated publications were screened for relevance based on titles and abstracts, of which 52 were reviewed in full text. Results: Twenty-four articles met inclusion criteria and were included in the qualitative synthesis. These articles discussed a range of topics, including the prevalence of service utilization, service use prior to a suicide death, and correlates of help-seeking. In general, the prevalence of service utilization was low and varied by suicidal history (eg, higher prevalence among individuals with a history of suicide attempts than those with suicide ideation only). Key facilitators (eg, current or history of suicidal thoughts, plans, or attempts) and barriers (eg, stigma) for service use and help-seeking were also identified. Discussion and Implications: Findings highlight the need for future studies and tailored services to improve age-appropriate and culturally responsive suicide prevention and intervention strategies for middle- to old-age adults.
