Project Details
About the Project
“It’s amazing what can happen when you just start the conversations.”
When an unattached pregnant person chooses a midwife to support their journey, their perinatal needs are well met. However, patients who develop perinatal mental health distress can face significant challenges in accessing mental health care. Family physicians can prescribe SSRIs, access some mental health services through their Primary Care Network (PCN), and refer to perinatal psychiatry, capabilities and resources that are not within the scope of midwifery, leaving these vulnerable patients with few options. Dr. Shana Johnston and Dr. Phillippa Houghton wanted to better understand how the system could support patients with mild to moderate perinatal mental health distress, and sought SIFEI funding for engagement among midwives, psychiatrists, and family physicians.
This isn’t the first time Dr. Johnston has started a conversation around maternal mental health. Her own experience led her to pilot an established post-partum support group format in Victoria, and later operationalize it within Island Health, creatively filling a notable gap in care and ensuring timely, appropriate support for Victoria’s new parent community. Her subsequent project on family practice support for midwifery clients with postpartum hypertension created connections that, two years later, led to an important boost for her newest project.
Jennifer Matheson-Parkhill, Site Director for South Island UPCCs, had heard about the gap in care for midwifery clients in accessing urgent medical care and saw a possible role for UPCCs to play in filling that gap. As a team, the group developed a trial pathway for unattached midwifery clients to access urgent medical care through the UPCCs and are currently trialing having perinatal mental health as one of the issues addressed through this pathway. While this work is still in its infancy with multiple barriers to overcome, it’s a significant first step in addressing this substantial gap in care for a key population at a vulnerable time. As Dr. Johnston says, “The importance of caring for those who are giving birth to and caring for the next generation cannot be overstated when we look at return on investment for healthcare dollars spent.”
Further, this innovative work has spurred high-level conversations at the operational level among MHSU, perinatal psychiatry, and public health to delineate a pathway for perinatal patients with mental health distress. Linkages to provincially-led efforts are beginning in this area as well and will hopefully ensure that this important work continues to move forward. What started as a simple engagement has truly grown wings.
Considering her experience with Facility Engagement-supported projects, Dr. Johnston observes, “We think the work we do is so linear: You do a thing and you get a result. But it’s not. In my experience, it’s the ripples that are created that have the biggest impact. You never know how the ripples created today will impact care in the future.” Midwifery patients will hopefully experience improved access to care for urgent medical issues and mild to moderate perinatal mental health distress with the newly-developed care pathway carved out by UPCCs, but it will also be interesting to see where the ripples from this engagement project will lead.
Sincere thanks to Drs. Shana Johnston and Phillippa Houghton (Family Practice); Drs. Jasmina Kobiljski and Stefanie Montgomery (Perinatal Psychiatry); Dr. Jane Ryan (Infant Psychiatry); Carrie Ellert, Adrienne Carruthers, Astrid Fritzche, and Rebecca Geddes (Midwifery); Shauna Kaziel (MHSUU Clinical Services Director); Tasha McKelvey (Regional ED MHSU); Erin O’Sullivan (Manager, Perinatal Psychiatry); Gen Moore (Coordinator, Perinatal Mental Health); Jennifer Matheson-Parkhill (Site Director, South Island UPCCs); and Dr. Christina Kay (Medical Health Officer). Your successful, collaborative efforts to support perinatal mental health are so appreciated!