Embedded Maternal Mental Health Care in a Pediatric Primary Care Clinic: A Qualitative Exploration of Mothers' Experiences.
Adult
Delivery of Health Care
Depression, Postpartum
/ therapy
Depressive Disorder, Major
/ therapy
Female
Health Services Accessibility
Humans
Mental Health Services
/ organization & administration
Middle Aged
Mothers
Patient Preference
Pediatrics
Primary Health Care
/ organization & administration
Psychiatry
Qualitative Research
Social Stigma
behavioral health
health services
maternal child health
postpartum depression
primary care pediatrics
Journal
Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145
Informations de publication
Date de publication:
Historique:
received:
22
03
2019
revised:
26
07
2019
accepted:
05
08
2019
pubmed:
20
8
2019
medline:
1
9
2020
entrez:
20
8
2019
Statut:
ppublish
Résumé
The American Academy of Pediatrics recommends screening parents for postpartum depression during pediatric primary care visits. Unfortunately, many women who screen positive do not obtain treatment. Providing mental health services for women in the same location as their children's primary care may facilitate treatment, but few such clinics exist. We designed a qualitative study to evaluate women's perceptions and experiences with receiving mental health services from psychiatrists embedded in a safety-net pediatric primary care clinic. Semistructured interviews were conducted with women receiving mental health care from embedded psychiatrists in a safety-net pediatric clinic. Data were analyzed using an inductive approach. Twenty women participated. Five major themes emerged: 1) barriers to maternal mental health care, including psychiatric symptoms impairing access, stigma, and fear of Child Protective Services; 2) benefits of embedded care, including convenience, low barrier to entry and trust; 3) motherhood as facilitator to care, with early motherhood described as a time of vulnerability to relapse; 4) focus on parenting, including appreciation for parenting skills and normalization of the mothering experience; 5) treatment modality preferences, including concerns about medications and a preference for psychotherapy. Postpartum women face many barriers to psychiatric care. Mental health care embedded within the pediatric setting lowers barriers to care during this critical period. These insights should inform further collaboration between adult psychiatrists and pediatric care providers.
Identifiants
pubmed: 31425791
pii: S1876-2859(19)30371-7
doi: 10.1016/j.acap.2019.08.004
pmc: PMC6907070
mid: NIHMS1537596
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
934-941Subventions
Organisme : NICHD NIH HHS
ID : K23 HD080876
Pays : United States
Organisme : NCRR NIH HHS
ID : KL2 RR024130
Pays : United States
Organisme : NIMH NIH HHS
ID : R25 MH060482
Pays : United States
Informations de copyright
Copyright © 2019 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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