Integrated perinatal mental health care: a national model of perinatal primary care in vulnerable populations

Lomonaco-Haycraft, Kimberly C.; Hyer, Jennifer; Tibbits, Britney; Grote, Jennifer; Stainback-Tracy, Kelly; Ulrickson, Claire; Lieberman, Alison; Bekkum, Lies van; Hoffman, M. Camille

doi:10.1017/s1463423618000348

Cited by 38 publications

(31 citation statements)

References 30 publications

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“…The University of Colorado integrated model screens all women at intake and during the third trimester. High-risk women are additionally screened 2 weeks postpartum (Lomonaco-Haycraft et al, 2018). Defining screening intervals and identification of patients at high-risk junctures during pregnancy will be important investigations in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Integrated models that incorporate mental health services into perinatal care are emerging. A major advantage of an integrated model is that patients are four times more likely to follow-up (FU) with mental health services when offered in tandem with obstetric services compared with being treated outside of the obstetric clinic (Judd, Stafford, Gibson, & Ahrens, 2011; Lomonaco-Haycraft et al, 2018; Melville et al, 2014; Poleshuck & Woods, 2014; Sit et al, 2009). A small study in rural Australia ( n = 107) reported successful integration of a mental health clinic within the confines of an obstetric clinic to treat PPD using experienced psychiatric nurses trained in perinatal mental health.…”

Section: Introductionmentioning

confidence: 99%

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Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination

Goedde

Zidack

et al. 2020

J Am Psychiatr Nurses Assoc

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BACKGROUND: A fully integrated Obstetric Mental Health Clinic (OBMHC) was established in 2007 in the rural northwest United States to address perinatal depression. AIMS: The purpose of this mixed methods study was to examine depression outcomes in women receiving outpatient psychiatric services between 2007 and 2017 at a fully integrated OBMHC and to explore patient and obstetric team perceptions of OBMHC experiences. METHOD: A retrospective database study was employed; depression was measured at baseline and follow-up visits using the Edinburgh Postnatal Depression Scale. Descriptive statistics, regression models, and trend analysis were employed to determine effectiveness. A subset of patients participated in telephone interviews; the obstetric team was surveyed regarding perceptions of the service. RESULTS: The sample included 192 women (195 pregnancies). Approximately 72% experienced less depression by the first follow-up visit. Patients taking three or more psychiatric medications attended more OBMHC visits. Trend analysis indicated that women with the highest levels of depression had the best response to the intervention. Three qualitative themes emerged: Safe Place, Mental/Emotional Stability, and Integrated Personalized Approach. Obstetric team members ( n = 11) perceived the clinic to be helpful and noted improved access to mental health care. CONCLUSION: OBMHCs can be effective when psychiatric nurses are embedded within an outpatient obstetric service. Improved access, timely services, and patient reassurance can lead to an improved pregnancy experience and reduced depressive symptoms. The longevity of this clinic’s experience serves as a role model for other centers to replicate this successful integrated model of care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination

Goedde

Zidack

et al. 2020

J Am Psychiatr Nurses Assoc

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“…Further, among mothers with subthreshold levels of trauma-related distress, additional prevention efforts targeting avoidance behaviors and bolstering emotional awareness (e.g., mindfulness techniques, in vivo exposure to feared stimuli) may be warranted. Last, given that pregnant women and their partners engage more regularly with the healthcare system, models of integrated perinatal care offer an ideal opportunity for increased screening and intervention efforts (Lomonaco-Haycraft et al, 2019).…”

Section: Theoretical and Empirical Implicationsmentioning

confidence: 99%

Prenatal negative affectivity and trauma-related distress predict mindful parenting during toddler age: Examining parent–infant bonding as a mechanism

2021

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Despite findings demonstrating the importance of parental present-centered awareness, factors undermining mindful parenting have received less attention. Increasingly, evidence points to parental psychopathology as a salient risk factor for parenting difficulties. Thus, the goal of the present study was to investigate specific dimensions of parental trauma-related distress and general negative affectivity during pregnancy as predictors of mindful parenting during toddler age. Parental psychopathology, parent–infant bonding, and mindful parenting were assessed in a sample of heterosexual couples (N = 159) across four waves of data collection spanning pregnancy to child age two. Data were analyzed using path analysis within a dyadic framework. Results demonstrated the unique impact of maternal trauma-related distress during pregnancy (e.g., intrusions and avoidance) on facets of mindful parenting more than two years later. Further, among both mothers and fathers, general negative affectivity common across internalizing disorders undermined mindful parenting through impaired parent–infant bonding. Findings highlight the need for early intervention efforts that incorporate mindfulness strategies to reduce subthreshold symptoms of prenatal psychopathology, promote healthy bonding, and improve parental awareness and self-regulation, thereby enhancing the overall parent–child relationship.

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“…The World Health Organization's reproductive health programme has made maternal mortality reduction its primary goal [20]. Mental health screening during pregnancy has been endorsed by the American College of Obstetricians and Gynecologists, the United States Preventive Services Task Force, and the American Academy of Pediatrics as a way to improve pregnancy outcomes such as preterm birth and low birth weight, as well as maternal-child health and wellness in the long run [21].…”

Section: Introductionmentioning

confidence: 99%

Perinatal And Post-Partum Care From Early Pregnancy To Postpartum Period.

Yadav¹,

Moktan²,

Shrestha³

et al. 2021

JUSST

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Introduction: Despite the fact that just a few researchers have examined the prenatal and postpartum periods, the findings from those few studies suggest an increase in prevalence through out pregnancy and the first six months after delivery. Pregnancy is a pivotal period in a woman’s life, as she experiences significant emotional, physical, hormonal, and social changes. Pregnancy and the first six months after delivery (perinatal phase) can be taxing, leading in sleep deprivation, relationship difficulties, and feelings of isolation. Materials & Methods: Quality of care, perinatal care, India, hospital, intrapartum care, implementation, and still birth for period were searched in the PubMed database using MeSH terms. A narrative summary of the goals and outcomes was completed. Conclusions: This study compiles a list of all prenatal social needs interventions that have been described in the literature to date. The majority of therapies have been for IPV, according to the findings of this study, and interventions that combine counselling or ongoing support have the best likelihood of lowering social risk factors and improving clinical outcomes.

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Integrated perinatal mental health care: a national model of perinatal primary care in vulnerable populations

Abstract: Implementation of a universal screening process for PMADs alongside the development of an IBH model in perinatal care has led to the creation of a program that is feasible and has the capacity to serve as a national model for improving perinatal mental health in vulnerable populations.

Cited by 38 publications

References 30 publications

Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination

Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination

Prenatal negative affectivity and trauma-related distress predict mindful parenting during toddler age: Examining parent–infant bonding as a mechanism

Perinatal And Post-Partum Care From Early Pregnancy To Postpartum Period.

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