Mental Health Care Disparities After Implementation of a Perinatal Depression Intervention [ID: 1377829]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 141; no. 5S; pp. 39 - 39S
• Main Authors: Spalding, Hannah, Byatt, Nancy, Leung, Katherine, Simas, Tiffany Moore, Yeboah, Tracy
• Format: Journal Article
• Language: English
• Published: 01.05.2023
• ISSN: 0029-7844
• DOI: 10.1097/01.AOG.0000930228.75174.89

INTRODUCTION: Perinatal depression affects upward of 1:7 childbearing individuals and is associated with significant negative intergenerational outcomes, especially when unrecognized and untreated. Our study examined provider perinatal depression screening, assessment, treatment, and follow-up by race and ethnicity, as a proxy for implicit bias or systemic racism, after a perinatal depression intervention was implemented. METHODS: The Program In Support of Moms (PRISM), an obstetric practice intervention, was implemented in November 2017 at the UMass ob-gyn resident clinic. PRISM aims to improve the detection, assessment, treatment, and follow-up of patients with perinatal depression. With IRB approval, we abstracted data from charts of patients having one or greater prenatal or postpartum visits with an Edinburgh Postnatal Depression Screen (EPDS) score equal to or greater than 10 between October 2017 and May 2020. Descriptive statistics were used for comparisons. RESULTS: Seven hundred ninety individuals were included (White n=369, Black n=84, Hispanic n=264, other n=73). There were significant differences by race and ethnicity in the assessment of prior mental health history, interest in treatment engagement, therapy referrals, and medication treatment offered (all P ≤.001) with White patients having significantly higher rates than patients who were Black or another race. There were no differences by race and ethnicity in provider positive screen acknowledgement, provision of psychoeducation, or repeat screening after a positive screen. CONCLUSION: Racial disparities in assessment, referral, and medication treatment offerings exist after a perinatal depression intervention. Implementation of PRISM intervention with an anti-racist lens is needed to improve equitable access to mental health care for those marginalized by racism.