L10 – A Proactive Perinatal Mental Health Care Management Program Based on Collaborative Care Principals to Facilitate Engagement and Address Obstacles to Care in Women Veterans

Summary

It has long been recognized that perinatal mental health conditions are common and, if not treated, can lead to poor outcomes for mothers, infants and families. Despite this, a minority of women who experience mental health symptoms in the peripartum period receive treatment. Further, screening alone for mental health symptoms among women in the peri-partum is insufficient to ensure adequate treatment is obtained. There is therefore a critical need for effective and proactive programs to provide support, address barriers to care, and facilitate engagement in care, especially in at-risk populations where rates of mental health conditions are elevated. Obstacles to care include limited access to mental health services, inadequate information and education regarding perinatal mental healthcare and treatments, stigma, fragmentation of services, and difficulty navigating healthcare systems. Fortunately, the Collaborative Care Model provides an effective framework to address these obstacles. We present a Perinatal Care Management Program designed to promote engagement and address obstacles to care in one at risk population, women Veterans using VA maternity care in the Veterans Affairs San Diego Healthcare System, where all these challenges exist. This proactive program is based on the principals Collaborate Care Model with modifications to address the specific needs of women Veterans in the peripartum and includes targeted screening, education, triage, referral management, access to appropriate treatment, care management, measurement-based care, and coordination of care. Modern approaches including virtual care are leveraged to reduce patient burden and increase access. The interprofessional perinatal care coordination team, consisting of RN care manager, psychologist, and psychiatrist makes optimal use of limited resources to maximize timely access to specialized care and promotes interdisciplinary coordination of care. Presenters will give an overview of the program and how it is working in the VA San Diego Healthcare System including discussion of obstacles to implementation, lessons learned, and possible applications within other at-risk populations and in non-federal healthcare settings.