1 / 18

Parental Depression Screening Implementation

Parental Depression Screening Implementation. Bill Stratbucker, MD, MS, FAAP Amy Williams, LMSW Preventive Services Improvement Project Learning Session January 21-22, 2011. Objectives. Understand the expectations of primary care clinicians for parental depression screening

herne
Download Presentation

Parental Depression Screening Implementation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Parental Depression Screening Implementation Bill Stratbucker, MD, MS, FAAPAmy Williams, LMSW Preventive Services Improvement Project Learning Session January 21-22, 2011

  2. Objectives • Understand the expectations of primary care clinicians for parental depression screening • Discuss appropriate timing, tools, referral, referral tracking and follow-up • Develop a plan for establishing community linkages for parents with depression

  3. Clinician Expectations • What do Bright Futures 3rd Edition and the AAP say? • What is the prevailing sentiment among pediatric clinicians? • Who else is worrying about parental depression?

  4. Background • One of the greatest risk factors for child behavioral and mental health problems • Short and long-term effects of parental depression • Lifetime prevalence is 16.6% • Postpartum depression occurs in 10-20%

  5. Risk Factors for Perinatal Depression • Personal history of depression • Family history • History of substance abuse • Teenage parent • Stressful pregnancy, delivery • Low-income • Spouse without depression is protective factor

  6. Barriers to Screening • Time • Lack of reimbursement • Ownership of problem • Lack of community mental health resources • Lack of training on screening methods and implementation strategies

  7. Case for Pediatric Clinician Screening • Early access to parent-infant dyad • Established continuity of care • Understand the divergent outcomes • OB colleagues not necessarily convinced • Benefits outweigh the risks • The right thing to do

  8. Implementation • When? How frequent? • What tool? Back-up tool? Diagnostic tool? • Who delivers the questionnaire? • Who scores? • Who responds to the result?

  9. Pre-implementation steps • Staff education • Community linkages awareness • Work flow established • Make office screen-friendly • Educate parents • Prenatal visits • Birth hospitalization • First Week Well Visit

  10. Pre-implementation steps • Billing • 99420 • Set charge amount • What if insurance doesn’t cover? • Can’t selectively charge patients

  11. Maternal Depression: PHQ-9

  12. Maternal Depression: PHQ-2

  13. Positive Screens Discussion with parent Reassurance (blues) Demystification Education *Diagnostic evaluation and treament Resource referral Mental health, OB, PCP referral Emergent disposition Follow-up

  14. Spectrum Health Example • Screening at birth hospitalization • Prenatal and postnatal MOMS program • Perinatal Mood Disorders Team • Perinatal Mood Disorders Support Group • Pine Rest Mental Health day program for affected mother-infant dyads • General Pediatrics, PHQ-2 screening • Co-located LMSWs

  15. Resourse Available to Anyone • Postpartum Support International • www.postpartum.net • Early Intervention • Early Head Start • Mother’s Morning Out programs • www.MedEdPPD.org

  16. Establishing Community Linkages • Networking • Establish contacts • Community organizations • Hospital (nursing, social work) administration • Obstetricians • Mental health institutions, providers • Insurance companies • Support groups

More Related