Improving Access to Perinatal Mental Health and Substance Use Disorder Treatment

Perinatal mental health and substance use disorders are the most common complication of pregnancy and a leading cause of pregnancy-related deaths in the United States. Despite high prevalence (10 – 20%), these conditions are often not detected or treated. Thus, there is an urgent need for innovative approaches that increase access to treatment. Building the capacity of frontline clinicians working in primary care, perinatal care and the Neonatal Intensive Care Unit (NICU) can help increase access to perinatal mental health care. In this presentation we will: 1) describe four approaches to building frontline provider capacity to provide perinatal mental health care: Project ECHO, NICU based perinatal mental health treatment, telemental health programs, and Perinatal Psychiatry Access Programs, and 2) discuss gaps in care and implications for policy.







< !< Amritha Bhat, MD, MPH will describe one of the first applications of the Extension for Community Healthcare Outcomes (ECHO) model to perinatal mental health. Dr. Bhat will present a mixed-methods analysis of program evaluation data (evaluation surveys n=25 and semi-structured interviews with participants n=9) to understand whether MAP ECHO improved frontline provider knowledge and skills to manage perinatal mental health conditions.

< !Sarah Nagle Yang, MD will outline a perinatal mental health interdisciplinary clinician education program delivered through ECHO Colorado. The presentation will include descriptive statistics of participants (n=30), pre- and post- data on clinician confidence and knowledge, and qualitative data from post-ECHO surveys.

< !Meredith Spada, MD will describe the development of a screening and referral process for postpartum depression at a high-volume, level III NICU, with a focus on the mother-baby dyad. The presentation will include a descriptive analysis, as well as a discussion of the screening algorithm, lessons learned, and future plans.

< !Marra Ackerman, MD will describe data on patient utilization and satisfaction with perinatal telemental health (TMH) care in an academic clinical practice prior to the COVID 19 pandemic (N=45). These findings will be explored in the setting of large-scale expansion of TMH practices and inform return to office practices. TMH offers unique opportunities to observe the mother-child dyad in the home environment, and can offer opportunities for earlier and more frequent assessment in the post-partum period.

< !Nancy Byatt, DO, MS, MBA, FACLP - State and federal legislation has led to the establishment of numerous statewide Perinatal Psychiatry Access Programs (Access Programs). Access Programs aim to build the capacity of frontline medical providers to address perinatal mental health and substance use disorders. This presentation will: 1) provide a taxonomy of Access Program components and implementation strategies used in these population-level interventions, 2) characterize the variation in Access Program implementation across the nation, and 3) discuss the policy implications, remaining gaps in care, and next steps