Doctors define the “perinatal period” as running from before conception, through a woman’s pregnancy, all the way to a year post-partum. It’s a time when women go through many changes physically - and mentally. But for women who struggle with mental health or substance abuse issues - these changes not only can affect the mother, but the child as well.
April 30 through May 7 is Maternal Mental Health Awareness Week. While many doctors specialize in the physical health of mothers, there is a drastic shortage of specialists in perinatal psychiatric care providers. To address this need, the Medical College of Wisconsin and UW-Milwaukee joined forces with the help of a grant from the United Health Foundation to launch a new primary and psychiatric health care program – the Periscope Project.
The project uses a variety of tools, such as real time provider-to-provider teleconsultations with a perinatal psychiatrist, a community resource database, and provider education resources and technologies to better serve mothers struggling with mental health and substance abuse disorders. Since its launch last summer, the project has released a follow-up report that examines data collected from its launch in July of 2017 through February 2018.
Periscope Project medical director Dr. Christina Wichman says that so far they have had phenomenal feedback. "One hundred percent of (providers) said that they would not only utilize that information for that individual patient that they called for, but also be able to disseminate that information to other patients within their practice," she notes.
There are 330 providers enrolled to date, according to Jennifer Doering, associate professor in the College of Nursing at UW-Milwaukee and lead evaluator for the Periscope Project.
And, she adds, approximately 25-30 percent of the teleconsultations result in connecting providers with additional community resources. This helps fill the care gap and "be a bridge" for women who often do not have the time or resources to see additional doctors, Doering explains.
"What we know is that women who receive these referrals don't always, and in fact most often don't, access those referrals. So in essence, by a provider making a referral that never gets accessed, you are delaying care and you are reducing missed care opportunities by that patient walking out with that plan," she says.
"At least that patient's already been put on the right path rather than having no care at all in those intervening months," adds Wichman. "Whereas before if they had no support, a lot of providers are hesitant to even do a screening tool because if it's positive (they) don't know what to do next."
Wichman notes that the data and feedback collected was only from providers. However, providers have told the Periscope Project that their patients are very grateful that these needs are being addressed.
In order to extend this service beyond the grant period, Doering says this data will help find a long-term solution by showing the cost effectiveness and positive results that keep women in the care of their primary doctors. "If we are meeting a need and we can demonstrate our effectiveness long-term, then securing the funding and the mechanism for reimbursing the service is important to us," she says.
One significant change to the program since its launch is making the content available to all healthcare providers and health care professionals. "Our true front line providers - social workers, lactation consultants, nurses, home visitors - had such an impact on perinatal moms, as well. Why shouldn't we open up this service to them too?" notes Wichman. "Any healthcare provider or health care professional can access our service, but then we really tailor the scope of the consultation to the provider who's calling. Because we're impacting a provider, one's going to assume that that provider is reaching many patients' lives."