National Cross-Sectional Study of Mental Health Screening Practices for Primary Caregivers of NICU Infants

Abstract

Universal screening for postpartum mood and anxiety disorders (PMADs) has been recommended for all new parents at outpatient postpartum and well-child visits. However, parents of newborns admitted to the NICU are rarely able to access these services during their infant’s prolonged hospitalization. The objective of this study was to determine the prevalence of mental health screening and treatment programs for parents or other primary caregivers in NICUs across the country. In this cross-sectional study, US NICU medical directors were invited to complete an online survey about current practices in mental health education, screening, and treatment for primary caregivers of preterm and ill infants in the NICU. Comparative analyses using Fisher’s exact test were performed to evaluate differences in practices among various NICU practice settings. Survey responses were obtained from 75 out of 700 potential sites (10.7%). Of participating NICUs, less than half routinely provided caregivers with psychoeducation about mental health self-care (n = 35, 47%) or routinely screened caregivers for PPD or other mental health disorders (n = 33, 44%). Nearly one-quarter of the NICUs did not provide any PMAD screening (n = 17, 23%). Despite consensus that postpartum psychosocial care is essential, routine mental health care of primary caregivers in the NICU remains inadequate.

Preterm infant mental health in the neonatal intensive care unit: A review of research on NICU parent‐infant interactions and maternal sensitivity

“…Such services can include assessments and interventions that support NICU parent‐infant relationships. However, despite these increasing levels of awareness and guidelines around appropriate psychological supports, there is significant heterogeneity in practice and resources, with many NICUs providing minimal mental health services during the NICU admission and post‐discharge (Bloyd et al., 2022). Furthermore, the NICU medical teams and staff at many hospitals receive only limited training on infant and parent mental health, trauma‐informed care, and the factors that support or harm the developing parent‐infant relationship (Scala et al., 2022).…”

Recognizing Early Warning Signs of Acute Hypertensive Crisis of the Postpartum Mother: An Important Role for Neonatal Nurses

“…Neonatal nurses are often the care clinicians who have the most consistent contact with mothers and families with infants in the NICU. [7][8][9][10] Trust Test questions for the activity are provided in this issue; the posttest and evaluation must be completed online. Sign into your Academy of Neonatal Nursing (ANN) account or create a nonmember account at academyofneonatalnursing.org if you are not a member.…”

“…Complications caused by hypertensive disorders in pregnant and postpartum women are leading causes of maternal morbidity and mortality. Several next steps are critical in supporting the health and well-being of postpartum mothers and their infants: 8,44 1. Increase maternal awareness of the potential for acute hypertensive crisis in postpartum mothers.…”

Addressing caregiver mental health in the neonatal ICU

“…Mental health programmes that are integrated into routine NICU care are therefore the ideal setting to provide brief behavioural interventions that directly address the mental health of caregivers in the indirect service of the child [25]. Despite these recommendations, only 44% of NICUs routinely screened using any method, only 47% provided parental education about mental health or services, and 24% did not screen at all [26 ▪▪ ].…”