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
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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.
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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
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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
Nancy.Byatt@umassmemorial.org
Tiffany Moore Simas, MD, MPH, MEd, FACOG
Lead Obstetric Liaison
Tiffany.MooreSimas@umassmemorial.org
Kathleen Biebel, PhD, Program Director
Kathleen.Biebel@umassmed.edu
Shums Alikhan, BA, Program Assistant
Shums.Alikhan@umassmed.edu
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!