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Massachusetts Child Psychiatry Access Program for Moms: Utilization and Quality Assessment

Byatt, Nancy, DO, MS; Straus, John, MD; Stopa, Arielle, BS; Biebel, Kathleen, PhD; Mittal, Leena, MD; Moore Simas, Tiffany A., MD, MPH

doi: 10.1097/AOG.0000000000002688
Mental Health: Original Research: PDF Only

OBJECTIVE: To describe the utilization and quality assessment of a population-based program to help health care providers address mental health and substance use disorders among pregnant and postpartum women, the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms).

METHODS: The Massachusetts Child Psychiatry Access Program for Moms builds health care providers' capacity to address perinatal mental health and substance use disorders through 1) trainings and toolkits, 2) telephonic access to perinatal psychiatric consultation, and 3) facilitating referral to community resources. Clinical encounter data were collected during telephone consultations. Focus groups were conducted with health care providers and staff from enrolled practices. In-depth interviews were conducted with patients served by the practices that participated in the focus groups. Transcribed interviews were analyzed by two researchers using an iterative, interpretive process with a grounded theory framework.

RESULTS: In the first 3.5 years, MCPAP for Moms enrolled 145 obstetric practices, conducted 145 trainings for 1,174 health care providers, and served 3,699 women. Of telephone consultations provided, 42% were with obstetric care providers–midwives and 16% with psychiatrists. Health care providers perceived that MCPAP for Moms facilitates health care providers detecting and addressing depression and women disclosing symptoms, seeking help, and initiating treatment. Obstetric practices reported that they need additional support to more proactively address and further improve depression care.

CONCLUSION: The high volume of encounters, sustained utilization over 3.5 years, and qualitative themes identified from health care providers and patients demonstrate that MCPAP for Moms is a feasible, acceptable, and sustainable approach to increasing access to evidence-based treatments for perinatal mental health and substance use disorders on a population-based level.

The Massachusetts Child Psychiatry Access Program for Moms is a sustainable approach to increasing access to evidence-based treatments for perinatal mental health and substance use disorders.

University of Massachusetts Medical School and UMass Memorial Health Care, Worcester, and Massachusetts Child Psychiatry Access Program, Massachusetts Behavioral Health Partnership, Beacon Health Options, and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Corresponding author: Nancy Byatt, DO, MS, University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, MA 01655; email: nancy.byatt@umassmemorial.org.

Supported by the Massachusetts Department of Mental Health and the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH) (grant numbers KL2TR000160, UL1TR000161).

Financial Disclosure Drs. Byatt, Straus, Biebel, Mittal, and Moore Simas have received salary, funding support, or both from the Massachusetts Department of Mental Health through the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms). Dr. Byatt is also the statewide Medical Director of MCPAP for Moms, has served on the Perinatal Depression Advisory Board for the Janssen Disease Interception Accelerator Program and Advisory Boards for Sage Therapeutics, is a council member of the Gerson Lerhman Group, and has served a speaker and consultant for Sage Therapeutics. Dr. Straus is Founding Medical Director of MCPAP. Dr. Biebel was the Program Director of MCPAP for Moms from 2013 to 2016. Dr. Mittal is the Associate Medical Director for MCPAP for Moms and an uncompensated coinvestigator for a clinical trial for Sage Therapeutics. Dr. Moore Simas is the Lead Obstetric Liaison for MCPAP for Moms, has served on Advisory Boards for Sage Therapeutics, and is a consultant for two research projects for Sage Therapeutics. She has also served a speaker for Sage Therapeutics. The other author did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal's requirements for authorship.

Received February 7, 2018. Received in revised form March 30, 2018. Accepted April 12, 2018.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.