docPromoting Maternal Mental Health During and After Pregnancy
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Promoting Maternal Mental Health During and After Pregnancy
Promoting Maternal Mental Health During and After Pregnancy Tiffany A. Moore Simas, MD, MPH, MEd, FACOG Lead Obstetric Liaison, MCPAP for Moms Associate Professor of Ob/Gyn and Pediatrics UMass Medical School/UMass Memorial Health Care Nancy Byatt, DO, MS, MBA, FAPM Medical Director, MCPAP for Moms Assistant Professor of Psychiatry and Ob/Gyn UMass Medical School/UMass Memorial Health Care October 21, 2015 ©MCPAP For Moms Disclosure Statement: Nancy Byatt, DO, MS, MBA, FAPM Tiffany A. Moore Simas, MD, MPH, MEd, FACOG With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the parties listed above (and/or spouse/partner) and any for-profit company which could be considered a conflict of interest 3 4 5 Gavin et al. Ob Gyn 2005, Vesga-Lopez et al. Arch Gen Psychiatry 2006. www.acog.org Perinatal depression is twice as common as gestational diabetes Depression 10-15 in 100 Diabetes 3- 7 in 100 Gavin et al. Ob Gyn 2005, Vesga-Lopez et al. Arch Gen Psychiatry 2006. ACOG Practice Bulletin 2013. Two-thirds of perinatal depression begins before birth Pregnancy 33% Before pregnancy 27% Wisner et al. JAMA Psychiatry 2013 Postpartum 40% Perinatal depression effects mom, child & family Poor health care Substance abuse Preeclampsia Maternal suicide Low birth weight Preterm delivery Cognitive delays Behavioral problems Bodnar et al. (2009). The Journal of clinical psychiatry. Cripe et al. (2011). Paediatric and perinatal epidemiology, Flynn, H. A., & Chermack, S. T. (2008). Journal of Studies on Alcohol and Drugs; Forman et al. (2007). Development and psychopathology, Grote et al. (2010). Archives of general psychiatry; SohrPreston, S. L., & Scaramella, L. V. (2006). Clinical child and family psychology review; Wisner et al. (2009). The American journal of psychiatry, Perinatal depression is under-diagnosed and under-treated Treated Women Untreated women Carter et al. (2005). Australian and New Zealand Journal of Psychiatry, 39(4), 255–261; Marcus et al. (2003). Journal of womens health 2002, 13(1), 373–380. Smith et al. (2009). General hospital psychiatry, 31(2), 155–62. 10 The perinatal period is ideal for the detection and treatment of depression Front line providers have a pivotal role Regular opportunities to screen and engage women in treatment 80% of depression is treated by primary care providers Barriers to Treatment Patient Provider Systems Lack of detection Fear/stigma Limited access Lack of training Discomfort Few resources Lack of integrated care Screening not routine Isolated providers Women do not disclose symptoms or seek care www.chroniccare.org Underutilization of Treatment Unprepared providers, with limited resources Poor Outcomes Transforming obstetrical practice to include depression care could provide a solution Massachusetts is leading the nation in perinatal mental health care 2010 July 2013 MA passes PPD Act, forms PPD Commission MCPAP for Moms funding July 2015 Insurance companies pay surcharge for MCPAP for Moms July 2014 MCPAP for Moms launch Education 855-MomMCPAP Care Coordination 1-855-Mom-MCPAP Telephone Consultation 1-855-Mom-MCPAP Telephone Consultation During telephone consult care coordination is determined based on acuity, severity and need Contact Provider Patient Contact Care coordinator will identify 2-3 targeted resources to deliver via phone or email Care coordinator will contact mom and work with her to schedule appointment Does not involve speaking with mom Care coordinator will follow up after 1 month 19 Telephone Consultation Obstetric providers/ Midwives Family Medicine Psychiatric Primary care Pediatric providers providers providers Please call us with any questions as we are to here to help you 1-855-Mom-MCPAP www.mcpapformoms.org In summary, our aim is to promote maternal and child health by building the capacity of front line providers to address perinatal depression Please contact us www.mcpapformoms.org Nancy Byatt, DO, MS, MBA, FAPM Medical Director [email protected] Tiffany Moore Simas, MD, MPH, MEd, FACOG Lead Obstetric Liaison [email protected] Kathleen Biebel, PhD, Program Director [email protected] Shums Alikhan, BA, Program Assistant [email protected] Copyright © MCPAP for Moms 2016 all rights reserved. Authors: Byatt N, Moore Simas, T, Biebel K. Funding provided by the Massachusetts Department of Mental Health. Thank you!
