Brief Oral Papers
Women's Mental Health
Marissa Beal, DO
Assistant Professor
Penn State College of Medicine
Hershey, Pennsylvania
Tran Dang, BS
Medical Student
Johns Hopkins School of Medicine
Baltimore, Maryland
Kristen Miller, MA
Research Program Assistant
Johns Hopkins University
Towson, Maryland
Lindsay Standeven, MD
Assistant Professor of Psychiatry at Johns Hopkins and the Clinical and Education Director of the Ce
Johns Hopkins
Baltimore, Maryland
Lauren Osborne, MD
Vice Chair of Clinical Research, Obstetrics & Gynecology
Weill Cornell Medicine
New York, New York
Background Methods We completed a retrospective chart review for patients who were referred by obstetricians or midwives to a social worker who triaged the patient and provided referral to establish care with the IPC. Patients were referred if they were pregnant or up to 6 weeks postpartum and interested in medication management with a reproductive psychiatrist. We compared all patients who engaged in care with the IPC from 2020-2022 as well as all patients who were referred to the IPC and did not engage in care. Chart review was completed to assess engagement in care, obstetric outcomes, healthcare utilization, and Edinburgh Postpartum Depression Scale (EPDS) scores. 52 patients were referred to the IPC from 2020-2022, with 48% (n=25) identifying as black and 42% (n=22) identifying as white. 30 patients engaged in the IPC and 22 patients did not engage in care. Of those who engaged in the IPC, 66% identified as white (p < 0.001) and 63% were privately insured (p=0.001) compared to those that did not engage where the majority identified as black (73%) and were publicly insured (81%). Patients who engaged in the IPC had a reduced no-show rate (11.42% vs 25.2%, p< 0.001) and were more likely to attend their 6-week postpartum visit (87% vs 50%, p=0.023). Further analyses will explore additional aims including differences in obstetric outcomes and depression scores. Discussion Engagement in the IPC was associated with decreased no-show rate and improved attendance rates at the 6-week postpartum visit. The patients who were referred to the IPC but did not attend were more likely to be black and publicly insured, indicating that further outreach methods may be necessary to improve engagement in care for these patients. Limitations include other confounders, such as severity of psychiatric illness which we were unable to control for as this was a retrospective chart review, but covariates will be included in future analyses. Conclusion References Grote NK, Katon WJ, Russo JE, et al. Collaborative care for perinatal depression in socioeconomically disadvantaged women: a randomized trial. Depress Anxiety. 2015;32(11):821-834. Hansotte E, Payne SI, Babich SM. Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review. Public Health Rev. 2017;38(1):1-17 Katon W, Russo J, Reed SD, et al. A randomized trial of collaborative depression care in obstetrics and gynecology clinics: socioeconomic disadvantage and treatment response. Am J Psychiatry. 2015;172(1):32-40.
Perinatal depression is common and there are many barriers to accessing psychiatric care during this time period (Hansotte et al., 2017). Collaborative and integrated care models have begun to address this gap in care, especially for patients who are socio-economically underserved and racial/ethnic minorities (Grote et al., 2015; Katon et al., 2015). We will present outcome data from our Integrated Perinatal Clinic (IPC) to assess for improvement in obstetric outcomes, healthcare utilization, and depression after engagement with this clinic.
Results
An integrated clinic may help improve outcomes for perinatal patients by increasing engagement with healthcare providers for general obstetric care throughout the perinatal period.
