Haitian Mamas: The Development and Two-Year Implementation of an OB/GYN-Based Preventive Behavioral Health Group in a...

Perinatal mental health conditions are among the leading causes of maternal mortality in the United States. However, 50% to 70% of perinatal mental health cases go undiagnosed, and of those diagnosed, fewer than 30% receive treatment. At Boston Medical Center, a large safety-net academic medical center in the northeastern United States (US), this treatment gap became apparent when new Refugee Women's Health Clinic patient visits increased by 138% following an influx of Haitian forced migrants starting in 2021. In response, we developed and implemented Haitian Mamas, a same-day access preventive behavioral health group within the Obstetrics and Gynecology department. This quality improvement study evaluates the development of Haitian Mamas from August 2023 to 2025, using four Plan-Do-Study-Act (PDSA) cycles. We evaluated the feasibility of this program across six domains: reach, engagement, integration of measurement-based care, financial viability, adaptability, and provider-perceived acceptability. Over two years, 196 women participated in the group, with an average of eight members per group, and there was a progressive improvement in integrating measurement-based care, which rose from 11.5% in Cycle 1 to 67.4% in Cycle 4. 35% screened positive for moderate to server mental health concerns. A thematic analysis of qualitative data from providers' weekly post-group reflections identified implementation barriers and facilitators for Haitian Mamas. Our findings suggest that the development and implementation of a same-day access, OBGYN-based preventive behavioral health group for perinatal patients in a safety-net hospital setting is operationally feasible.