A Pilot Investigation to Enhance Behavioral Health Referral for Perinatal, Low-Income Women With Mood Disorders

Abstract

Background Perinatal, low-income, ethnic minority women with mood disorders underutilize behavioral health treatment. A community–academic partnership was used to address behavioral health initiation among this population. Objectives We sought to examine the feasibility, acceptability, and preliminary outcomes of a behavioral health referral intervention with low-income, ethnic minority perinatal women diagnosed with mood disorders. Methods An open trial pilot study was conducted with 38 perinatal women. The behavioral health referral intervention consisted of two sessions of manualized referral strategies to enhance access to care. The main outcome was attendance at a behavioral health appointment. Results Approximately 55% of the perinatal women attended a behavioral health appointment within 2 months (i.e., initiated treatment). Intervention participation rates and ratings were high. Depression scores decreased from baseline to after the intervention. Conclusions The findings demonstrated favorable outcomes compared with other referral interventions. The behavioral health referral intervention shows promise for implementation in community settings.

Uptake of referrals for women with positive perinatal depression screening results and the effectiveness of interventions to increase uptake: a systematic review and meta-analysis

“…This uptake rate is considerably lower than those in other screening programs, such as cancer screening (Yabroff et al, 2003;Callen et al, 2012;Dalton, 2018). Such a low Education Education on the definition, symptom and hazard of perinatal depression, prenatal depression or postnatal depression for women with positive screening results, mostly in the form of brochures (Miller et al, 2004;Flynn et al, 2006;Chen et al, 2011;Wisner et al, 2013;Bina, 2014;Boyd et al, 2015;BenDavid et al, 2016;Trost et al, 2016;Bauer et al, 2017;Jarvis et al, 2018).…”

“…Education on the definition, symptom and hazard of perinatal depression, prenatal depression or postnatal depression for women with positive screening results, mostly in the form of brochures (Miller et al, 2004;Flynn et al, 2006;Chen et al, 2011;Wisner et al, 2013;Bina, 2014;Boyd et al, 2015;BenDavid et al, 2016;Trost et al, 2016;Bauer et al, 2017;Jarvis et al, 2018).…”

“…Assistance by health care provider for mental health specialist appointment or further assessment or treatment (Miller et al, 2004;Flynn et al, 2006;Gordon et al, 2006;Horowitz and Cousins, 2006;Horowitz et al, 2009;Reay et al, 2011;Rowan et al, 2012;Nelson et al, 2013;Boyd et al, 2015;BenDavid et al, 2016;Venkatesh et al, 2016;Kallem et al, 2019).…”

A Systematic Review of Interventions to Improve Initiation of Mental Health Care Among Racial-Ethnic Minority Groups

“…Three of the 19 studies that did not examine racial-ethnic differences in outcomes enrolled participants primarily from a mix of racial-ethnic minority groups (13,(35)(36)(37) (Table 2). These studies showed improvement in attendance of mental health clinics and reduced psychiatric hospitalization rates.…”

“…Uebelacker et al's (41) telephone-based care management intervention for Latinos with depressive symptoms resulted in no difference in outpatient visits or receipt of antidepressants between the intervention and the control groups. Boyd and colleagues (35) showed that a behavioral health referral intervention based on identification of barriers, effective solutions, systematic follow-up, and psychoeducation with a case manager led to improvement in scheduling appointments for mental health services and in appointment attendance.…”