A Stepped-Collaborative Perinatal Depression Model

J Am Psychiatr Nurses Assoc. 2019 Sep/Oct;25(5):376-384. doi: 10.1177/1078390318789252. Epub 2018 Aug 23.

Abstract

BACKGROUND: Perinatal depression (PD) screening has been defined for decades, but treatment remains ill-defined, with few mental health (MH) providers helping depressed women during this delicate time. The nurse practitioner (NP) is in a position to help women through PD with the use of a collaborative treatment model. AIMS: This DNP (doctor of nursing practice) inquiry investigated a stepped collaborative care model (CCM) to see whether the PD model improved time from referral to evaluation and decreased depression scores over a 6-month treatment period for women who came to an NP MH practice. METHOD: After obtaining approval from the institutional review board and the clients, the Edinburgh Postnatal Depression Scale was administered to 37 women at psychiatric evaluation and subsequent MH visits over a 6-month period. Time from referral to evaluation and depression scores were analyzed. RESULTS: The CCM met the goal of 30 days from referral to evaluation. Prenatal clients had a statistically significant decrease in depression scores, and postpartum client scores were clinically significant. CONCLUSION: A CCM among care providers facilitates prompt intake to treatment time within 1 month of identification of depression, and a decrease in depression scores in women measured by sequential depression screen scores. The study may provide ideas for evidence-based NP practice by use of the model to treat depression in this group of women.

Keywords: collaborative care; perinatal/postpartum depression; stepped care.

MeSH terms

  • Adult
  • Cooperative Behavior*
  • Depression, Postpartum / diagnosis*
  • Depression, Postpartum / therapy*
  • Female
  • Humans
  • Nurse Practitioners*
  • Pregnancy
  • Referral and Consultation*