Recognizing Maternal Mental Health: An Initiative to Improve Perinatal Depression and Anxiety Identification during Prenatal Visits Using a Standardized Screening Protocol

Authors

Breslin Therese Gillis, University of Tennessee, KnoxvilleFollow
Tracy L. Brewer, University of Tennessee, KnoxvilleFollow
Megan L. Young, University of Tennessee Medical CenterFollow
Heather Moss, Womens Care Group KnoxvilleFollow

Document Type

Poster

Publication Date

7-23-2024

Abstract

Background: Perinatal depression (PD) is a common pregnancy complication. There are several predictive risk factors for PD, including co-occurring anxiety. Mental health conditions are the leading cause of preventable perinatal deaths. Screening for depression and anxiety during prenatal visits is recommended for early identification, evaluation, treatment, and follow-up.

Local Problem: An obstetrics/gynecology clinic in East Tennessee lacked a process for screening depression and anxiety during prenatal visits. The project team established a process to screen for depression and anxiety at the 28-week prenatal visit. The aim was to screen 40% of women at the 28-week prenatal visit, with 60% of those who screened positive receiving evaluation by the provider and recommended behavioral health resources based on symptom severity.

Methods: The project was guided by the Johns Hopkins Evidence-Based Practice Model. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depression and anxiety. The counts of women who completed a screening, screened positive, and received recommended resources and referrals were measured through four PDSA cycles.

Interventions: An EPDS cut-off score of greater than or equal to 10 or a > 0 response to question 10 indicated a positive depression screen. While a score of greater than or equal to 5 from three anxiety-related questions from the EPDS indicated a positive anxiety screen. Women who screened positive were evaluated by a provider and received recommended resources and referrals.

Results: Out of 366 patients, 293 (80%) were screened at their 28-week prenatal visit. Utilizing the EPDS, 14% of patients screened positive for depression and 26% for anxiety. Forty-six out of 83 patients who had a positive depression and/or anxiety screen received behavioral health resources or treatment.

Conclusion: The EPDS was administered to patients at their 28-week prenatal visit over 80% of the time. Over half of those patients with a positive screen were further assessed by a provider to determine recommended resources, treatment, or referrals.

Recommended Citation

Gillis, Breslin Therese; Brewer, Tracy L.; Young, Megan L.; and Moss, Heather, "Recognizing Maternal Mental Health: An Initiative to Improve Perinatal Depression and Anxiety Identification during Prenatal Visits Using a Standardized Screening Protocol" (2024). Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP).
https://trace.tennessee.edu/dnp/119