Intent to seek help among women who participated in an online screening program for postpartum depression: Enabling factors according to the behavioral model for the use of health services

Postpartum depression (PPD) is a common mental health condition that can appear during pregnancy and up to one year after birth (Jones, 2022). It includes a range of symptoms that affect the mother’s daily functioning (Slomian et al., 2019) and can have negative consequences for both her and her family (Bina, 2020). Although many effective treatments for PPD exist, most women do not receive appropriate care (Azale et al., 2016). Even though PPD is common (Jones, 2022), many women do not seek professional mental health help (Bina, 2014).

The purpose of this study was to examine factors related to the intention to seek mental health help among women who participated in an online screening program for PPD, using the Behavioral Model of Health Services Use (Andersen, 1995). The study focused on predisposing factors (attitudes toward seeking help, social stigma, and feelings of loneliness), enabling factors (online social contact and preference for an online questionnaire over a face-to-face questionnaire), and a need factor (severity of PPD symptoms).

The research hypotheses were that positive attitudes, loneliness, online social contact, preference for the online questionnaire, and higher symptom severity would be positively related to intention to seek help, and that stigma would be negatively related to intention to seek help. It was also hypothesized that these variables would significantly explain intention to seek help in the regression model, and that history of mental health treatment would moderate the relationship between online social contact and intention to seek help.

The study included 726 women in the perinatal period, most of them (70.7%) postpartum, who were not receiving mental health treatment at the time of data collection. Recruitment took place in two ways: women who entered the “Going Through This Together” website of Keren Bri’ah, completed the screening questionnaire, and were then invited to join the study; and through posting a dedicated link on Facebook groups and social networks. Participants were 22-51 years old (M = 33.14); 82.4% had academic degrees, 73.2% had average or above-average income, and 35% reported a history of psychological treatment. All participants completed the EPDS and additional questionnaires. Half watched a short video showing online social contact among women who had experienced PPD, while the other half did not.

The findings showed that women who watched the video reported significantly higher intention to seek help compared to those who did not. Positive attitudes and feelings of loneliness were also significantly related to intention to seek help. Symptom severity was the variable most strongly related to intention to seek help, but the relationship was non-linear: a strong positive relationship was found only among women with lower EPDS scores (below 10). Contrary to the hypotheses, social stigma and preference for an online questionnaire were not significantly related to intention to seek help. The hierarchical regression model was significant. In the moderation analysis, the video had different effects depending on treatment history and symptom level: among women with treatment history, the video increased intention to seek help regardless of symptom severity, while among women without treatment history, the effect appeared only when symptoms were low.

The study highlights the importance of early identification of PPD symptoms and the potential value of online social contact as part of screening and support programs, especially for women with prior treatment experience. The findings show that symptom severity is a central factor in explaining intention to seek help, but its effect is not linear and may depend on personal factors such as treatment history. The results support continuing to develop online screening and support platforms that offer accessibility and anonymity, and that include content aimed at reducing stigma and encouraging help-seeking. This study is the first to examine intention to seek help following online screening for PPD, and to test the effect of online social contact through watching a video. The findings contribute to a deeper understanding of the factors that influence intention to seek mental health help in the context of PPD and offer important insights for designing more effective intervention strategies .