Mental Health

A Collaborative Approach to Connecting New Mothers to Mental Health Services
By Stephanie Costa, M.D., Kingsdale Gynecologic Associates
Chair, Department of OB/GYN, Riverside Methodist Hospital
 
I have been a practicing physician in the Columbus area for over twenty years. During that time I have enjoyed cultivating a deep relationship with patients, and I especially enjoy the partnership that develops over the course of one or more pregnancies with my patients. Understandably, it saddens me to see vibrant and loving young women affected by depression or anxiety. Because of the many changes that happen in the body during pregnancy and the postpartum period, women are at risk for developing mood disorders during this otherwise exciting time.  Couple that with social expectations to be strong, multitasking superwomen, and many of my patients start to struggle during their pregnancy. This can become increasingly problematic during the postpartum time when sleep deprivation and uncertainties about parenting, not to mention any pre-existing life circumstances or stressors, also come into play.
 
When I had identified depression or anxiety in my patients in the past, I found that attempts to connect patients to resources for counseling/therapy were less than ideal. It was very difficult and time consuming to try to find an affordable and accessible therapist for patients. When I learned about the planned work between the Healthcare Collaborative of Greater Columbus (HCGC) and Perinatal Outreach and Encouragement for Moms (POEM), I felt I needed to become involved in this effort to improve women’s access to quality mental health care. 
 
The recent collaboration between HCGC, POEM, and community OB/GYN’s and Pediatricians has already been impactful.  POEM has provided an easy, streamlined referral process that has markedly decreased the amount of time our office staff has spent making mental health referrals. Once our staff has made an online referral to POEM, our patients typically have a kind voice reaching out to them within 24 hours to arrange their mental health referral. This decreases stress on the patient, and gives them a source of hope that things will improve. Because of the communication back from POEM, I am better able to follow up on a treatment plan for patients. Another important benefit is the increased screening and awareness in our office. Instead of only screening at the postpartum visit, we are now screening at the initial OB visit, at the start of the third trimester, and again postpartum. Our pediatric partners are screening for depression and anxiety when new mothers are taking their baby in for newborn checkups. With the increased screening, patients are becoming aware of symptoms and realizing how common mood disorders are. Many women have not reached out for help previously. Now, I feel we are able to better identify mood disorders and refer before symptoms escalate.
 
By identifying depression or anxiety earlier, we are hoping to not only improve how women are feeling, but also to have an impact on the health of the infant. Studies have shown that infants born to mothers with anxiety or depression are at increased risk for growth restriction, difficult deliveries, feeding issues, bonding issues, and decreased mental development. Perhaps this work will ultimately reduce the rate of neonatal morbidity and mortality in our community in addition to improving the quality of life for mothers.  I have noticed that once we have identified anxiety or 
depression in a patient, then initiated treatment, women seem to enjoy their pregnancies more, and are better able to juggle the complexities of the postpartum period. Furthermore, when patients become pregnant again, they are recognizing symptoms and enlisting the help of available resources so they are better able to handle pregnancy and life stressors.
 
It has been rewarding and invigorating to join HCGC, POEM, and pediatric colleagues to make a meaningful impact on the health and well-being of women and infants in Central Ohio. It also makes me realize that if each one of us contributes in some small way, we can create a shift toward better health for our community.

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