Improving Perinatal Maternal Mental Health: Development of a Psychosocial Risk Assessment and Treatment Program
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Perinatal mental health and psychosocial concerns have long lasting effects on women and children. Health care facilities should have assessment and treatment programs in place. The purpose of this quality improvement project was to implement and evaluate a psychosocial risk assessment and treatment program that used the Edinburgh Postnatal Depression scale (EPDS) and the Antenatal Risk Questionnaire (ANRQ), to measure depressive symptoms and psychosocial risk factors in a rural Midwestern obstetric clinic. ANRQ and EPDS scores were then combined to calculate a Psychosocial Risk Index (PRI) and categorize risk as low, medium, or high. The Model for Improvement was used to implement the change. One hundred and seven participants were screened. Positive screens during each trimester were recorded along with referral and treatment plans based upon individual risk factors and assessment tool scores. The average patient age was 27 years, average gravida and parity was 2.8 and 1.4 respectively. Total average EPDS score was 5.55 and the average ANRQ score was 17.66. The average PRI risk of the three trimesters showed 58.7% of participants were low risk, 3% as medium risk, and 38.3% as high risk. The screening program increased overall awareness of mental health and psychosocial concerns that can occur during pregnancy.
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