(214) MOMs (Mental Health for Ohio Moms): A Survey-based Study to Assess Physician and Perinatal Women's Perspectives on Perinatal Mental Health Care Availability and Accessibility Across the State Of Ohio

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Background: Perinatal mood and anxiety disorders (PMAD) occur in 10-20% of all pregnancies(1). A staggering ‎‎75% of those affected with PMADs do not receive appropriate help(2). Our team is conducting the MOMs (Mental ‎Health for Ohio Moms) study with the goal of understanding the barriers that Ohio mothers and frontline providers ‎face in accessing care for and treating PMADs.‎

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Methods: This is a cross-sectional survey study with two arms. Institutional review board approval (IRB) was ‎obtained (#2022-0297). The first arm includes Ohio frontline providers’ (Obstetrics and Gynecology, Primary Care, ‎Family Practice, Pediatrics, and Psychiatry) survey which assesses provider's screening and referral practices, attitudes, ‎and knowledge related to PMADs. The providers were reached via email and postal mail. Second arm surveys ‎patients-Ohio Pregnant and postpartum women and assesses their awareness of PMADs and the barriers they face ‎when seeking care for the same. Patients are being recruited from Obstetric waiting rooms.‎

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Results: Provider survey- We have 247 responses which include 20% Obstetricians, 13% Psychiatrists, 28% ‎Primary care / Family Physicians, 33% Pediatricians.‎

‎68% identified Postpartum depression (PPD) as the most common complication of pregnancy. While 30% report ‎treating PMADs patients frequently, 74% report < 4 hours training in PMADs. Only 16% screen women for PMADs in ‎both pregnancy and postpartum. Major screening barriers are identified as lack of time (56%), limited availability of ‎referral sources (45%) and lack of staff (31%). Main barriers in connecting patients to mental health are - long waits for ‎appointments (85%) and lack of reproductive psychiatrists (69%). When asked what would best support them in ‎optimally treating PMADs patients, 80% identify easier access to Psychiatry, ~50% want embedded social work / ‎mental health, only 27% want teleconsultation support, 89% are interested in furthering education in PMADs.‎

Patient survey- We have 154 responses. 54% identified PPD as most common complication of pregnancy and 96% said ‎they had previously heard of PPD.‎

Main barriers in accessing mental health care are identified as severe depression (31%), lack of available appointments ‎‎(21%), poor knowledge of resources (18%), high cost of care (17%), worry about being prescribed medicine in ‎pregnancy(14%).Possible interventions that could help are identified as-mental health care embedded in obstetric ‎clinics (36%); lower cost of care (34%), easier appointment availability(33%), family education (32%), mental health ‎resources list (29%). About 2/3 of the sample voiced discomfort with taking medications during pregnancy and ‎breastfeeding. 80% report that PMAD education would have been helpful.‎

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Discussion: These are preliminary data as data collection is still in progress. We will have final results by August ‎‎31, 2023.‎

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Conclusion: We hope to draw conclusions about major barriers faced by Ohio women and frontline providers ‎in treating PMADs.‎

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References: ‎
‎1. Gaynes BN, Gavin N, Meltzer-Brody S, et al. Perinatal depression: Prevalence, screening accuracy, and screening ‎outcomes. Evid Rep Technol Assess (Summ). 2005;(119):1-8. doi(119):1-8. doi: 10.1037/e439372005-001 [doi]. ‎
‎2. Dowse E, Chan S, Ebert L, et al. Impact of perinatal depression and anxiety on birth outcomes: A retrospective data ‎analysis. Matern Child Health J. 2020;24(6):718-726. doi: 10.1007/s10995-020-02906-6 [doi].‎