11/12/2021 | 2:45 PM to 3:45 PM
Improving Front-line Clinician Capacity to Address Bipolar Disorder Among Perinatal Individuals: A Longitudinal Analysis of Massachusetts Child Psychiatry Access Program (MCPAP) for Moms
Methods: MCPAP for Moms clinical encounter data were examined from first use (7/2014) through 6/2020. MCPAP for Moms aims to increase clinician capacity via education, resource and referral, and psychiatric consultation encounters (phone with clinicians or face-to-face consultations with patients). Here, we assessed the effects of the encounter types that directly assist clinicians on a one-to-one basis (resource and referral, psychiatric consultations). We examined if utilization (number of annual encounters with the program in total and by encounter type) was associated with: (1) increased frequency of front-line clinicians providing direct mental health treatment for PMADs and (2) increased frequency of encounters which resulted in the frontline clinician proving direct treatment for bipolar disorder vs. other PMADs. Effects were estimated using longitudinal negative binomial models. Exploratory group-based trajectory modeling (GBTM) was used to examine sub-groups of clinician utilization.
Results: Since July 2014, 1,006 individual clinicians have utilized MCPAP for Moms. More frequent utilization of MCPAP for Moms was associated with increased rates of front-line clinicians providing direct mental health treatment (IRR=1.07, 95% CI:1.06 to 1.07), after adjusting for elapsed time and rural community. More frequent utilization of psychiatric consultations was more predictive of increased treatment rates than resource and referral encounters. Increases in face-to-face consultation utilization were associated with the greatest increase in rates of front-line clinicians providing direct mental health treatment to patients with BD (IRR=2.12, 95%CI:1.82 to 2.41). Based on sub-groups that emerged from GBTM, clinicians with MCPAP for Moms utilization patterns that were increasing over time exhibited the strongest association with providing direct mental health treatment to patients with BD (IRR=13.5, 95%CI:4.2 to 43.2).
Conclusions: Utilization of MCPAP for Moms facilitates front-line clinicians’ ability to provide direct mental health treatment to their patients, including those with complex illnesses like BD. This study contributes to early evidence supporting the Access Program model.
References
Rusner M, Berg M, Begley C. Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes. BMC Pregnancy and Childbirth. 2016;16(1):331.
Byatt N, Biebel K, Moore Simas TA, et al. Improving perinatal depression care: the Massachusetts Child Psychiatry Access Project for Moms. Gen Hosp Psychiatry. 2016;40:12-17.
Authors
Speakers
Grace Masters
MD/PhD student UMass Medical School
Yiyang Yuan
Doctoral student University of Massachusetts Medical School
Nien Chen Li
Doctoral student UMass Medical School
John Straus
Medical Director Special Projects Beacon Health Options
Tiffany Moore Simas
Chair of Dept Ob/Gyn; Professor of Ob/Gyn, Pediatrics, Psychiatry, Pop & Quant Health Sciences University of Massachusetts Medical School/UMassMemorial Health
Nancy Byatt
Professor of Psychiatry, Ob/Gyn and Population & Quantitative Health Sciences University of Massachusetts Chan Medical School
Outpatient Consultation Brief Oral Papers
Category
General Sessions
Description
CE Hours
Presenting Author
Grace Masters
MD/PhD student | UMass Medical School