UNMET MENTAL-HEALTH NEEDS OF WOMEN IN PUBLIC-SECTOR GYNECOLOGIC CLINICS

OBJECTIVE: We examined the mental health needs of poor young women see n in public-sector gynecologic settings. STUDY DESIGN: Participants we re 205 ethnically diverse women, mean age 29 years, seen by gynecologi sts at San Francisco General Hospital, all either uninsured or receivi ng public medical assistance. An interview with an instrument designed to diagnose mood, anxiety, alcohol, and eating disorders in medical p atients, the Prime-MD, was used to assess current mental disorders. An y history of sexual or other physical assault was recorded. Receipt of primary care Was scored for comprehensiveness. RESULTS: The rates of current psychiatric disorders were extremely high; 21.5% had current m ajor depression. The prevalence of anxiety disorders was also elevated among these women. Many had a history of sexual trauma, and 28% had b een the victims of unwanted intercourse. Finally, many reported behavi ors that pose serious health risks. For example, 32% smoked and 2% use d illicit drugs. Fewer than half bad access to comprehensive primary m edical care. CONCLUSIONS: Young, poor women who seek care in public-se ctor gynecologic clinics would benefit from comprehensive medical care addressing their psychosocial needs.