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The Perinatal Mental Health Professional: Prevention at the Right Place and the Right Time

Projectomschrijving

Inzet van Perinatale Mental Health Professional bij psychische klachten tijdens de zwangerschap

Doel

Meer dan 1 op de 5 vrouwen ervaart psychische klachten tijdens de zwangerschap of vlak na de geboorte. Deze klachten kunnen een negatief effect hebben op zowel de moeder als het (ongeboren) kind. Helaas deze psychische klachten vaak niet opgemerkt of behandeld.

Aanpak

Dit project gaat onderzoeken of de introductie van een Perinatal Mental Health Professional (PMHP) in de geboortezorg de detectie en behandeling van psychische klachten kan verbeteren. De PMHP kan direct hulp bieden en indien nodig doorverwijzen naar ander hulpverleners. Zij vormt hierdoor een spin in het web in de psychosociale zorg voor zwangeren.

Verwachte resultaten

We verwachten dat de PMHP ervoor zorgt dat vrouwen met psychische klachten eerder opgespoord en geholpen worden, wat zal helpen om elke moeder en baby de juiste zorg op het juiste moment te geven.

Samenwerkingspartners

Dit project betreft een samenwerking tussen Radboudumc, Radboud Universiteit, Coöperatie Verloskundigen Nijmegen, Kraamzorg Zuid-Gelderland, en Jeugdgezondheidszorg.

Verslagen


Samenvatting van de aanvraag

BACKGROUND AND RELEVANCE (PROBLEM). During the perinatal period, more than 1 in 5 women in community populations have clinically meaningful maternal mental health (MMH) problems. MMH problems can negatively affect mothers and they can worsen over time. Moreover, MMH problems can negatively affect the (unborn) infant, both during the prenatal and the postnatal phase. The importance of a healthy first 1000 days --the time span roughly between conception and the second birthday-- for a person’s lifelong mental and physical health has been shown time and time again. Indeed, MMH problems during pregnancy are associated with birth complications and long-lasting behavioral, cognitive, and physiological changes in the child. This means that over time, problems that the mother experienced during the perinatal period can potentially profoundly impact the child’s life. In turn, this can result in increasing cumulative economic costs and societal burden. Early prevention and treatment of MMH problems is hence efficient and of large societal value. However, MMH problems frequently go unnoticed and untreated in pregnancy. Recently, we showed that while 22% of pregnant Dutch women in midwifery care report anxiety and depression symptoms above clinical cutoff scores, most are untreated: only 15% of these women with MMH problems receive some kind of treatment. High risk populations, such as ethnic minorities and families with low socio-economic status, are even more vulnerable for psychological problems (two- to threefold increase) and more difficult to reach for healthcare professionals. The percentage receiving adequate support and treatment may even be lower in these populations. In sum, there is an urgent need to screen and help women suffering from perinatal MMH problems, preferably as early as possible in pregnancy, with the goal of preventing problems from arising or deteriorating. GOALS OF THE STUDY (SOLUTION). This project’s ultimate goal is to contribute to the prevention of the known negative effects of MMH problems for both mother and child. To this end, the project will research whether the introduction of a Perinatal Mental Health Professional (PMHP) in standard perinatal care can profoundly improve early detection, prevention, and treatment of (risk factors for) MMH problems in women during the perinatal period. Also, the project will investigate how clients and perinatal professionals experience the presence of a PMHP in perinatal care. The proposed PMHP fits perfectly with the conclusions of a recent report of the Dutch Ministry of Health, Welfare and Sport (Actieprogramma Kansrijke Start), that states that positioning a professional in charge of detecting psychosocial problems at midwife practices may improve existing deficiencies in screening and support. APPROACH. The PMHP is a psychologist specialized in the perinatal period, who works closely with perinatal care professionals and organizes regular universal screening for MMH complaints. Women with MMH complaints are supported by the PMHP, who gives information and advice, carries out simple diagnostics, and provides short evidence-based treatment. When needed, the PMHP refers women for further treatment to a diversity of specialized partners (see Figure 1). The focus is on prevention and health promotion in an integral perinatal care approach, to ensure highly efficient support and treatment, as well as easy access to specialized professional expertise. Because the PMHP will have a leading role in providing the necessary information to the right professionals, this will result in short lines of communication, optimal transfers to the postnatal care professionals, and the best opportunities for clients’ mental health. METHOD. Two groups of women (N=500 each) recruited in early pregnancy will be compared: an intervention group routinely screened for MMH problems and receiving PMHP care and/or referrals in a systematic, yet personalized manner, and a control group receiving care as usual. The midwife practices/hospitals in both groups will be matched for size (deliveries/year), and population (e.g., SES, urban/rural ratio) from the Consortium Geboortezorg Oost. EXPECTED OUTCOME. We expect that the presence of a PMHP will result in more women with MMH problems being detected and provided with support, and in significantly improved maternal wellbeing, as compared to not having a PMHP. We expect clients and perinatal professionals to be positive about the PMHP and to offer useful points to improve and refine the PMHP’s role. We expect perinatal professionals to be happy to have a psychologist in charge of MMH screening and offering easily accessible professional support to their clients, as well as to have the PMHP as a linking pin between the professionals. In time, we expect that the integration of PMHP’s in integral perinatal care will be a major step in efficiently and cost-effectively providing every mother and child with the right care at the right time.

Kenmerken

Projectnummer:
05430052110008
Looptijd: 50%
Looptijd: 50 %
2022
2026
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
prof. dr. C de Weerth
Verantwoordelijke organisatie:
Radboud Universitair Medisch Centrum