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Article
Patient, provider, and system-level barriers and facilitators to addressing perinatal depression
Psychiatry Publications and Presentations
  • Nancy Byatt, University of Massachusetts Medical School
  • Kathleen Biebel, University of Massachusetts Medical School
  • Rebecca Lundquist, University of Massachusetts Medical School
  • Tiffany A. Moore Simas, University of Massachusetts Medical School
  • Gifty Debordes-Jackson, University of Massachusetts Medical School
  • Jeroan J. Allison, University of Massachusetts Medical School
  • Douglas M. Ziedonis, University of Massachusetts Medical School
UMMS Affiliation
Department of Psychiatry; Department of Obstetrics and Gynecology; Department of Quantitative Health Sciences
Date
11-12-2012
Document Type
Article
Medical Subject Headings
Depression, Postpartum; Perinatal Care; Community Mental Health Services; Community Mental Health Centers
Abstract
Objective: To explore perinatal health care professionals’ perspectives on barriers and facilitators to addressing perinatal depression. Background: Perinatal depression is common and associated with deleterious effects on mother, foetus, child and family. Although the regular contact between mothers and perinatal health care professionals may make the obstetric setting ideal for addressing depression, barriers persist, and depression remains under-diagnosed and under-treated. Methods: Four 90-minute focus groups were conducted with perinatal health care professionals, including obstetric resident and attending physicians, licensed independent practitioners, nurses, patient care assistants, social workers and administrative support staff. Focus groups were transcribed, and resulting data were analysed using a grounded theory approach. Results: Participants identified patient-, provider- and system-level barriers and facilitators to addressing perinatal depression. Provider-level barriers included lack of resources, skills and confidence needed to diagnose, refer and treat perinatal depression. Limited access to mental health care and resources were identified as system-level barriers. Facilitators identified included targeted training for perinatal health care professionals’, structured screening and referral processes, and enhanced support and guidance from mental health providers. Conclusion: A complex set of interactions between women and perinatal health care professionals contributes to perinatal depression being untreated. Service gaps could be closed by addressing identified barriers through integrated obstetric and depression care and enhanced collaborations. Future intervention testing could include targeted training, improved access, and mental health provider support to empower perinatal health care professionals’ to address perinatal depression, and thereby improve delivery of depression treatment in obstetric settings.
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Citation: Nancy Byatt, Kathleen Biebel, Rebecca S. Lundquist, Tiffany A. Moore Simas, Gifty Debordes-Jackson, Jeroan Allison, Douglas Ziedonis. (2012) Patient, provider, and system-level barriers and facilitators to addressing perinatal depression. Journal of Reproductive and Infant Psychology. 2012 Nov;30(5):436-449. DOI: 10.1080/02646838.2012.743000

Citation Information
Nancy Byatt, Kathleen Biebel, Rebecca Lundquist, Tiffany A. Moore Simas, et al.. "Patient, provider, and system-level barriers and facilitators to addressing perinatal depression" Vol. 30 Iss. 5 (2012)
Available at: http://works.bepress.com/nancy_byatt/10/