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Text messaging to support a perinatal collaborative care model for depression: A multi-methods inquiry.

Amritha Bhat1, Johnny Mao1, Jürgen Unützer1

  • 1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.

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Summary

Text messaging is feasible and acceptable in perinatal Collaborative Care (CC) programs, improving patient access to mental health support. Further research is needed to understand how message content impacts perinatal depression outcomes.

Keywords:
Collaborative carePerinatal depressionText messaging

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Area of Science:

  • Perinatal mental health
  • Digital health interventions
  • Collaborative Care models

Background:

  • Integrating mental health into obstetric care enhances access to perinatal depression treatments.
  • Digital communication, like text messaging, can further improve patient access to care.

Purpose of the Study:

  • To describe the implementation of text messaging within a perinatal Collaborative Care (CC) program.
  • To explore the association between text messaging content and perinatal depression outcomes.

Main Methods:

  • Analysis of data from an open treatment trial of perinatal CC in a rural obstetric clinic.
  • Inclusion of 25 women with Patient Health Questionnaire-9 score ≥10 enrolled in CC.
  • Assessment of text messaging acceptability via surveys and focus groups; analysis of message content and usage patterns.

Main Results:

  • Care Managers (CMs) initiated 85.4% of messages, with 86.9% patient response rate.
  • CMs used texts for appointment reminders; patients sought obstetric and parenting information.
  • CMs expressed concerns regarding boundary violations, while patients valued asynchronous communication.

Conclusions:

  • Text messaging is a feasible and acceptable modality within perinatal CC programs.
  • Further research is required to determine the effectiveness of specific text messaging content and response protocols on perinatal depression.