Abstract
This study was developed to evaluate the feasibility of implementing systematic depression screening in a large obstetric
practice and to evaluate the degree that detection and referral led to linkage with behavioral healthcare. Depression screening
was conducted using the Edinburgh Postnatal Depression Scale, administered at the initial pregnancy care appointment. Patients
at or above a predetermined score of 14 were advised to seek further behavioral health assessment through the patient’s behavioral
healthcare coverage. Within 4 weeks of screening, those referred were contacted by telephone, by clinic staff, to determine
whether they had pursued behavioral healthcare as recommended. Limited available data for newly established postdelivery screening
were similarly evaluated. All 2,199 newly presenting pregnant women who were seen in our obstetric clinics from September
2008 to May 2009 were screened for depression, and 102 (4.6%) scored at or above an EPDS of 14. Follow-up calls revealed that
none had pursued further behavioral health assessments. Of these 2,199, screening and follow-up data were available for 569
women at their 6-week postdelivery visit. Of these, 28 (4.9%) were above EPDS of 14, and 5 (17.9%) reported pursuit of further
behavioral healthcare following screening and referral. Peripartum depression can be addressed with systematic screening,
and the electronic medical record can readily be used to monitor results. Detection and referral at the beginning of pregnancy
did not lead to intended linkage with behavioral healthcare, but detection and referral postdelivery had a modest influence.
Barriers to pursuing behavioral healthcare need to be discovered and addressed.
practice and to evaluate the degree that detection and referral led to linkage with behavioral healthcare. Depression screening
was conducted using the Edinburgh Postnatal Depression Scale, administered at the initial pregnancy care appointment. Patients
at or above a predetermined score of 14 were advised to seek further behavioral health assessment through the patient’s behavioral
healthcare coverage. Within 4 weeks of screening, those referred were contacted by telephone, by clinic staff, to determine
whether they had pursued behavioral healthcare as recommended. Limited available data for newly established postdelivery screening
were similarly evaluated. All 2,199 newly presenting pregnant women who were seen in our obstetric clinics from September
2008 to May 2009 were screened for depression, and 102 (4.6%) scored at or above an EPDS of 14. Follow-up calls revealed that
none had pursued further behavioral health assessments. Of these 2,199, screening and follow-up data were available for 569
women at their 6-week postdelivery visit. Of these, 28 (4.9%) were above EPDS of 14, and 5 (17.9%) reported pursuit of further
behavioral healthcare following screening and referral. Peripartum depression can be addressed with systematic screening,
and the electronic medical record can readily be used to monitor results. Detection and referral at the beginning of pregnancy
did not lead to intended linkage with behavioral healthcare, but detection and referral postdelivery had a modest influence.
Barriers to pursuing behavioral healthcare need to be discovered and addressed.
- Content Type Journal Article
- Category Original Article
- Pages 1-6
- DOI 10.1007/s00737-012-0262-6
- Authors
- Paul Rowan, Division of Management, Policy, and Community Health, School of Public Health, The University of Texas, 1200 Herman Pressler Street, Houston, TX 77030, USA
- Anthony Greisinger, Kelsey Research Foundation, Houston, TX, USA
- Brenda Brehm, Kelsey Research Foundation, Houston, TX, USA
- Frances Smith, Kelsey–Seybold Clinic, Houston, TX, USA
- Edward McReynolds, United Healthcare, Houston, TX, USA
- Journal Archives of Women’s Mental Health
- Online ISSN 1435-1102
- Print ISSN 1434-1816