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Perinatal Mental Health in Colorado: What We Know and What We Can Do National PRAMS Conference Atlanta – December 8 th & 9 th, 2008.

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Presentation on theme: "Perinatal Mental Health in Colorado: What We Know and What We Can Do National PRAMS Conference Atlanta – December 8 th & 9 th, 2008."— Presentation transcript:

1 Perinatal Mental Health in Colorado: What We Know and What We Can Do National PRAMS Conference Atlanta – December 8 th & 9 th, 2008

2 Objective Describe a successful public health intervention addressing Perinatal Depression

3 Perinatal Depression Baby Blues –up to 2 weeks after birth –clears up without treatment –prevalence could be as high as 80% Perinatal Depression –clinical depression, requires treatment –occurs within the first year after birth –prevalence estimated at 10-20% Postpartum Psychosis –dangerous to mother and child –Exceedingly rare:.01% or 1 in 1000 women

4 Why Should We Care? Perinatal depression is the most common complication of childbirth, but it can be treated successfully Can be debilitating to mother and cause unnecessary pain and suffering Impact on the child and family: –Decreases mothers caregiver capacity –Studies show increase in childs risk for: Social/emotional problems Cognitive and linguistic delays Poor self-control, aggression, relationship problems Difficulty in school as older children

5 Postpartum Depressive Symptoms (PDS) Colorado PRAMS data for –N=6,000 –Prevalence estimated at 13.9% –70,000 births per year in Colorado = almost 10,000 women per year with PDS

6 Main Factors Associated with Postpartum Depressive Symptoms Demographic Characteristics: – Maternal Age (Under age 25) – Race/Ethnicity (Black/African-American) – Education (Lower education attainment) – Marital Status (Unmarried) – Poverty (Low income) Experience of Abuse Excessive Stress Low Birthweight Low Breastfeeding Duration

7 Prenatal Plus Demographics 84% are single 41% have less than 12 years of education 31% are teenagers (age < 18) 23% have a history of child abuse 22% have a history of, or are currently experiencing, domestic violence 26% have 4 or more High Life Stress indicators 42% have a history of, or a current, psychiatric diagnosis (including depression)

8 Prenatal Plus Overview Prenatal Plus Program provides case management services to Medicaid- eligible pregnant women in Colorado Services are provided throughout pregnancy and up to 2 months postpartum by a care coordinator, mental health professional and dietitian

9 Perinatal Depression Screening and Intervention

10 Purpose of Intervention To begin addressing the issue by identifying, educating and facilitating treatment for women at highest risk for perinatal depression Ultimate goal is to reduce the prevalence and duration of this serious mental health issue

11 Intervention Preparation Increase skill in staff to provide perinatal depression education to clients and to identify, screen, refer and provide brief counseling to women Increase community awareness of Prenatal Plus and client mental health needs Improve capacity of community resources to treat perinatal depression effectively

12 Short Term Intervention Outcomes Increase womans knowledge of Perinatal Depression Increase her awareness of resources Increase her motivation and self- efficacy to seek help Decrease sense of helplessness and despair

13 Intervention Protocol

14 The Edinburgh Postnatal Depression Scale Simple 10 item scale Designed to screen for depression in women during childbearing years Does not evaluate physical signs of depression such as sleep difficulties since these symptoms can also be associated with pregnancy and newborn care Does not replace clinical judgment – the scale does not detect moms with anxiety neuroses, phobias or personality disorders.

15 Evaluation Tools Data Collection –% women educated –% women screened/% screened + –% referred to treatment –% entering treatment (if known) –Type of additional support provided Client Exit Survey

16 Conclusion To increase identification and treatment of perinatal depression… Conduct regular and universal screening Provide appropriate education, resources and referrals Facilitate treatment and offer follow-up …For ALL women throughout pregnancy and postpartum.

17 Resources for Perinatal Depression Womens Health Perinatal Depression Website: womens/ppd/index.html womens/ppd/index.html

18 Thank You! Mandy McCulloch, Prenatal Plus Program Director


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