Improving perinatal depression care: the Massachusetts Child Psychiatry Access Project for Moms

• Published in: General hospital psychiatry Vol. 40; pp. 12 - 17
• Main Authors: Byatt, Nancy, DO, MS, MBA, Biebel, Kathleen, PhD, Moore Simas, Tiffany A., MD, MPH, MEd, Sarvet, Barry, MD, Ravech, Marcy, MSW, Allison, Jeroan, MD, MS, Straus, John, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Adult; Depression; Depressive Disorder - diagnosis; Depressive Disorder - therapy; Female; Humans; Massachusetts; Perinatal; Postpartum; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - therapy; Program Development; Program Evaluation; Psychiatry; Quality Improvement; Treatment; Young Adult; Pregnancy; Perinatal; Depression; Treatment; Postpartum
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2016.03.002

Abstract Objective Perinatal depression is common and associated with poor birth, infant and child outcomes. Screening for perinatal depression alone does not improve treatment rates or patient outcomes. This paper describes the development, implementation and outcomes of a new and low-cost population-based program to help providers address perinatal depression, the Massachusetts Child Psychiatry Access Project (MCPAP) for Moms. Method MCPAP for Moms builds providers' capacity to address perinatal depression through (1) trainings and toolkits on depression screening, assessment and treatment; (2) telephonic access to perinatal psychiatric consultation for providers serving pregnant and postpartum women; and (3) care coordination to link women with individual psychotherapy and support groups. Results In the first 18 months, MCPAP for Moms enrolled 87 Ob/Gyn practices, conducted 100 trainings and served 1123 women. Of telephone consultations provided, 64% were with obstetric providers/midwives and 16% were with psychiatrists. MCPAP for Moms costs $8.38 per perinatal woman per year ($0.70 per month) or $600,000 for 71,618 deliveries annually in Massachusetts. Conclusion The volume of encounters, number of women served and low cost suggest that MCPAP for Moms is a feasible, acceptable and sustainable approach that can help frontline providers effectively identify and manage perinatal depression.