Abstract
INTRODUCTION: The American College of Obstetricians and Gynecologists (ACOG) recommends that treatment for mental health disorders be equitably available and accessible to all pregnant women. We detail the implementation of a perinatal mental health program within a statewide maternal–fetal medicine (MFM) practice. METHODS: A retrospective quality improvement study was conducted among pregnant patients at a large, private MFM practice in New Mexico from October 2021 to September 2023. The primary outcome aimed to describe implementation of a perinatal mental health program and determine the demand for care of mood and anxiety disorders among pregnant patients being seen for antenatal high-risk obstetric care. RESULTS: In October 2021, an initial psychiatric mental health nurse practitioner (PMH-NP) employed by our MFM practice began providing care to pregnant patients. In June 2022, a second PMH-NP joined and a third was added in February 2023. No advertising of this new program was conducted to better serve existing patients. Patients are screened during each MFM visit with the Patient Health Questionnaire 9 (PHQ-9), a nine-item depression scale. Patients scoring higher than 4 were offered consultation with the PMH-NP and the patient elected to then schedule the visit. Additionally, patients with mood or anxiety disorders listed on their active problem list were queried by a clinician, offered consultation with the PMH-NP, and the patient elected to then schedule the visit. In 2021, 47 patients were seen with a total of 96 visits. In 2022, 284 patients were seen with a total of 1,046 visits. In 2023, 367 patients were seen with a total of 1,331 visits. CONCLUSION: Although ACOG recommends mental health treatment be available for all pregnant women, New Mexico lacks sufficient services. Implementation of a perinatal mental health program integrated within our MFM practice was successful with strong uptake by patients and year-over-year growth.
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