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Building Bridges

Lessons from a Pittsburgh Partnership to Strengthen Systems of Care for Maternal Depression

by Donna J. Keyser, Ellen Burke Beckjord, Ray Firth, Sarah Frith, Susan L. Lovejoy, Sanjith Pillai, Dana Schultz, Harold Alan Pincus

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Between January 2007 and June 2010, members of the Allegheny County Maternal and Child Health Care Collaborative designed, implemented, and evaluated the Allegheny County Maternal Depression Initiative, a local systems-change effort focused on increasing identification, referrals, and engagement in treatment as needed and appropriate for women at high risk for maternal depression. The collaborative was successful in improving key organizational and clinical processes related to the achievement of its aims. This report describes how and why the initiative was created, the processes through which it was implemented and evaluated, and the results and lessons learned. It concludes with recommendations in four areas for practice and policy change designed to expand and sustain the initiative's achievements: improve identification of maternal depression, enhance access to available resources and services, increase engagement in behavioral health treatment, and improve overall systems performance.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Methods

  • Chapter Three

    Results

  • Chapter Four

    Discussion

  • Chapter Five

    Conclusions

  • Appendix A

    Organizations and Leaders Participating in the Allegheny County Maternal Depression Initiative

  • Appendix B

    Protocol for the Allegheny County Maternal Depression Initiative

  • Appendix C

    Initiative Release-of-Information Forms

  • Appendix D.1

    Screening Tools: Edinburgh Postnatal Depression Scale

  • Appendix D.2

    Screening Tools: Patient Health Questionnaire 2

  • Appendix E.1

    Educational Tools: Consumer Pamphlet on Maternal Depression

  • Appendix E.2

    Educational Tools: Resource List for Consumers and Providers

  • Appendix E.3

    Educational Tools: “Prescription for Good Health”

  • Appendix F.1

    Implementation Tools: Decision Aid for Triaging Consumers at High Risk for Maternal Depression

  • Appendix F.2

    Implementation Tools: Referral Fax Form/Physical Health Managed Care Organizations

  • Appendix F.3

    Implementation Tools: Referral Information on Home-Based Service Programs

  • Appendix G.1

    Data-Collection Tools: Focus Group Protocol

  • Appendix G.2

    Data-Collection Tools: Sample Provider/Managed Care Organization Care Manager Survey

  • Appendix G.3

    Data-Collection Tools: Sample Training Evaluation

  • Appendix G.4

    Data-Collection Tools: Stakeholder Group Discussion Guide

This work was conducted under contract with UPMC for You. It was funded by a consortium of local and state organizations. The research was performed in RAND Health, a division of the RAND Corporation.

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