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Training, Resources Needed for Perinatal Care Clinicians Treating Psychiatric Disorders

April 16, 2021

(Part 1 of 2)

Training, consultation, resources and referrals are necessary to assist perinatal care clinicians at the “front line” be able to detect, assess, and treat mood and anxiety disorders and substance use disorders, said Nancy Byatt, DO, MS, MBA, FACLP.

In this video, Dr. Byatt discusses this and other key takeaway points from her upcoming session at the 2021 American Psychiatric Association Annual Meeting titled “Population-Based Approaches for Patients in Medical Settings: Delivering More Equitable Care?” She also discusses pertinent recent research and solutions to the challenges facing integrated perinatal psychiatric care.

In part 2 of this series, Dr. Byatt discusses the importance of treating perinatal individuals’ mental health and substance abuse disorders for the welfare of both themselves and their infant, and how recent research can impact policy in the field. 

Read the transcript:

I'm Nancy Byatt. I'm a perinatal psychiatrist, and I direct a statewide program called MCPAP for Moms, which is the Massachusetts Child Psychiatry Access Program for Moms in Boston. I also direct a center at The University of Massachusetts Medical School, Worcester, called Lifeline for Families.

Our center focus is on building the capacity of the medical community to be able to help the medical community address the mental health and substance use disorders that occur among pregnant and postpartum individuals.

I'm also an associate professor of Psychiatry, obstetrics/gynecologist (OB/GYN), and Population and Quantitative Health Sciences at University of Massachusetts Medical School.

Q: What are the main takeaways from your upcoming APA session?

A: The main takeaways from our session focused on population-based approaches to psychiatric care in medical settings. The first point, I would say, is that there's never going to be enough access to psychiatric care, no matter how many psychiatrists we train over the next decades or any of our lifetimes.

Access to psychiatric care is extraordinarily challenging. No matter how much training we have, no matter how much we build capacity within our field, it will never be enough to provide access to all the individuals that need psychiatric care in our communities. That's one takeaway.

Another takeaway is that a way to potentially address this is to build the capacity of clinicians who are at the front line in medical settings to be able to help them detect, assess, treat, follow up, and monitor psychiatric illnesses.

That way, we can increase access to care by building the capacity of clinicians in the community and in medical settings.

Q: Can you expand on your section of the upcoming session?

A: When we think about addressing psychiatric care using population approaches for perinatal individuals—when I say perinatal, I'm referring to individuals who are pregnant or within the first year after delivery—when we think about that setting, there's a few important takeaways there.

One is that perinatal mood, anxiety, and substance use disorders are common. They occur in one in five individuals. The second is that we know they have a negative impact. They impact birth outcomes, they impact pregnancy outcomes, they impact child outcomes later on.

The third thing is that similar to the general population, there will never be enough psychiatrists to provide care for the people who need psychiatric care during this time period.

Our work, and our team, and the work that we presented focuses on how we can build frontline provider clinician capacity to address this. There's a couple of ways to do this.

One, is there's been a proliferation of statewide programs. They're called perinatal psychiatry access programs. What those programs do is they provide training, consultation, and resource and referral to help clinicians at the front line be able to detect, assess, manage, follow up mood and anxiety disorders and substance use disorders during this time period.

A high-level summary of what we've found is that over time, when frontline clinicians start to treat psychiatric illness themselves, they start to treat more complicated illness and they become more comfortable.

We found this in several of our studies at our center and we also see that now that these programs are being implemented across the country, there's now 16 of these perinatal psychiatry access programs across the country.

The other take home point is they're population-based programs that cover a very large number. If we take our program in Massachusetts, which is called the Massachusetts Child Psychiatry Access Program for Moms, Boston, that program, we have 72,000 births in Massachusetts.

By the statewide access program, any provider in the state can call us, we can provide consultation, and we can help them manage their patients. We can also provide a face to face consultation for the provider when we meet with the patient directly and give recommendations back to the provider.

When we do that, we typically can get them in within a week or 2.

In summary, these access programs are a way to provide access to care for large populations by having, for example, a whole region or state be able to get this training, consultation, and resource and referral. That thereby increases access to care.

Nancy Byatt, DO, MS, MBA, FACLP, is a perinatal psychiatrist and physician-scientist focused on improving health care systems to promote maternal mental health. She is an Associate Professor of Psychiatry, OB/GYN, and Population and Quantitative Health Sciences at University of Massachusetts Medical School, Worcester. Dr. Byatt founded and is the Medical Director of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, Boston. She is the Founding Director of the Division of Women’s Mental Health within the Department of Psychiatry at the University of Massachusetts Medical School. She also founded and is the Executive Director of Lifeline4Moms, a center focused on helping the health care community optimize perinatal mental health. Dr. Byatt has had continued federal funding for research focused on developing and testing scalable interventions for addressing perinatal mental health and substance use disorders in medical settings. She frequently serves on national advisory boards and expert work groups focused on improving perinatal mental health.

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