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Beyond Screening: A Stepped Care Pathway for Managing Postpartum Depression in Pediatric Settings
Su-Chin Serene Olin1, Mary McCord2,3, Ruth E K Stein4
11 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York.
Journal of Women'S Health (2002)
|April 15, 2017
Summary
Untreated postpartum depression (PD) harms mothers and infants. A stepped care approach in pediatric primary care can effectively screen and manage PD, improving maternal and child well-being.
Area of Science:
- Pediatrics
- Psychiatry
- Public Health
Background:
- Untreated postpartum depression (PD) has severe consequences for maternal and infant health.
- Systematic perinatal depression screening is recommended, but lacks benefit without intervention systems.
- Pediatric primary care offers frequent contact with postpartum women via well-child visits, ideal for PD detection.
Purpose of the Study:
- To present a stepped care approach for screening and managing postpartum depression (PD) within pediatric settings.
- To integrate existing pediatric-based models into a flexible and responsive care pathway.
- To improve child well-being by addressing maternal PD in the family-centered medical home.
Main Methods:
- Systematic screening for depression symptoms.
- Systematic risk assessment for positive screens.
- Care management tailored to risk profiles and intervention responsiveness.
Main Results:
- A stepped care model allows pediatric providers to flexibly manage most PD cases.
- Integration into pediatric primary care can improve maternal and child outcomes.
- Addresses challenges and discusses implications for practice, policy, and research.
Conclusions:
- A stepped care approach is effective for screening and managing postpartum depression in pediatric primary care.
- This model enhances the ability of pediatric providers to support maternal mental health.
- Optimizing care within the medical home setting benefits both mother and child.