Perinatal Mood and Anxiety Disorders Screening Program: It's More Than Depression
- Describe the development and implementation of a Perinatal Mood and Anxiety Disorders Screening Program in a community hospital
- Identify the obstetrical patients at risk for developing a perinatal mood and anxiety disorder and the resources and services available for the at risk population
- Identify lessons learned from program evaluation and describe next steps of program expansion to support at risk patients in the community.
Edward Hospital has partnered with Linden Oaks Behavioral Health Hospital to develop a Perinatal Mood and Anxiety Disorders Screening and Treatment Program. The term postpartum depression has expanded to perinatal mood and anxiety disorders because women are at risk from conception through the first year postpartum. Patients are at risk for experiencing generalized anxiety with depression, panic disorder, post traumatic stress disorder, obsessive compulsive disorder, bipolar disorder, and psychosis. This poster presentation describes the process of developing, implementing, and evaluating a multi-faceted perinatal mood and anxiety disorders screening and treatment program in a 317 bed community hospital.
Proposed change:
Screening obstetrical patients for postpartum depression began as a pilot program using the Boyer Screening Tool. All patients were screened in the immediate postpartum period. Interventions from the screening results may include a follow-up phone call, assessment with a psychiatric nurse liaison and/or social worker, counseling with a trained psychologist, or referral to a psychiatrist. The total percentage of patients that scored “at risk” mirrored the latest research in postpartum depression with a rate of 20-22%. Of the women screened, 2-3% required some type of psychiatric services.The pilot program has now evolved into a comprehensive program involving a multidisciplinary team.
Implementation, outcomes and evaluation:
Patients are now educated and screened prenatally in 3 large OB practices as well as the high risk Perinatal Clinic. Inpatient services include educating and screening all birthing mothers on perinatal mood and anxiety disorders and the support services available. Referrals are made based on the individual needs of the patient. Outpatient services now include 2 support groups led by a licensed psychologist and psychotherapist, and a postpartum mood disorders specialist. A dedicated phone line is provided for women and their families who may be concerned about postpartum depression.
Implications for nursing practice:
Follow-up evaluation found the majority of women complied with recommendations and reported feeling less depressed and more capable of caring for their child. Early screening and intervention prepares mothers and improves outcomes. Future expansion of the program includes the development of more online options, including an online support group. Several pediatricians are screening new moms during well baby visits. Education, the screening tool, and referral options have been provided to support their staff. Plans for expansion include adding more obstetric and pediatric physician practices, refining the screening process, and providing services to surrounding hospitals.
Keywords: postpartum depression, perinatal mood disorder, postpartum depression screening, Boyer
