PUBH698 Final Presentation

Summary

This capstone project investigates the impact of the implicit program on mental health referrals for birthing persons at the Institute for Family Health. By comparing referral rates in 2017 and 2023-2024, the study found a significant increase in referrals post-implementation of the implicit model. This structured preventative care model, which screens for depression and other health factors during well-child visits, demonstrated a strong association with improved mental health referral rates. The findings support the importance of structured screening and referral systems in enhancing postpartum mental health care delivery.

Takeaways

• 😀 The capstone project focuses on examining the impact of the implicit program on mental health referrals for birthing persons at the Institute for Family Health.
• 😀 The implicit program is a structured, preventative care model that screens birthing persons for depression, smoking, family planning, and folic acid use during every well-child visit.
• 😀 The project compares mental health referral rates in 2017 (pre-implicit) with those in 2023 and 2024 (post-implicit).
• 😀 Postpartum depression affects 1 in 8 birthing persons nationally, with 11.9% of birthing persons in New York State reporting symptoms.
• 😀 A common barrier to screening and referral for postpartum depression includes time constraints, lack of knowledge about screening tools, and insufficient information on treatment options.
• 😀 The study conducted a retrospective cohort analysis using linked medical records to compare mental health referral rates before and after the implicit program.
• 😀 The study found a significant increase in the predicted probability of mental health referrals after the implicit model's implementation, from 2% in 2017 to 6% in 2023-2024.
• 😀 After adjusting for demographic factors like age, race, and ethnicity, the probability of receiving a mental health referral was still higher in the post-implicit period, further supporting the program's effectiveness.
• 😀 Crude logistic regression models indicated that birthing persons in the post-implicit period were 6.3 times more likely to be referred for mental health services compared to those in the pre-implicit period.
• 😀 After adjustments for age and race/ethnicity, the odds of receiving a mental health referral were nearly 4 times higher in the post-implicit period, suggesting that the program's effect remained strong.
• 😀 The study concludes that implementing the implicit model was associated with improved mental health referral rates, and recommends further research to investigate whether those referred initiated or completed mental health treatment.

Q & A

What is the primary objective of the capstone project presented by Kari Beachch?

The primary objective of the project was to examine whether implementing the implicit model led to an increase in mental health referrals among birthing persons receiving care at the Institute for Family Health.

What does the implicit program aim to address in birthing persons?

The implicit program aims to minimize pre-term and low birth weight infants by screening birthing persons for depression, smoking, family planning needs, and folic acid use during every well-child visit.

What specific mental health issue is the implicit program attempting to impact?

The implicit program is attempting to impact postpartum depression, which affects approximately 1 in 8 birthing persons nationally.

What were the key barriers identified that prevent effective screening and referral for postpartum depression?

Key barriers to effective screening and referral include providers' time constraints, lack of knowledge about screening instruments, and insufficient information about available treatment options and community resources.

How did the study assess the impact of the implicit program on mental health referral rates?

The study conducted a retrospective cohort analysis using data from birthing persons at the Institute for Family Health. It compared referral rates in 2017 (pre-implicit) to those in 2023 and 2024 (post-implicit), using statistical methods like Pearson's G Squared test and logistic regressions.

What significant finding was observed regarding mental health referrals after the implementation of the implicit program?

The study found a significant increase in the predicted probability of mental health referrals after the implementation of the implicit model. The referral probability increased sharply in 2023 and 2024 compared to 2017, suggesting a strong association between the implicit program and improved referral rates.

How did demographic factors like age and race influence the results of the study?

Even after adjusting for demographic factors such as age, race, and ethnicity, the study still observed a meaningful increase in mental health referrals in the post-implicit period. This indicates that the improvement in referrals was likely due to the implicit model rather than demographic factors.

What were the odds of receiving a mental health referral for birthing persons seen post-implicit compared to those seen pre-implicit?

Birthing persons seen post-implicit had 6.3 times higher odds of receiving a mental health referral compared to those seen pre-implicit, and after adjusting for demographic variables, the odds were nearly four times higher.

What are the key strengths of the study mentioned in the presentation?

The study's key strengths include a large sample size, the use of real-world healthcare data, and the ability to conduct a direct pre-post comparison of mental health referral rates.

What recommendations for future research does Kari Beachch make based on the findings of the study?

Future research should focus on investigating whether birthing persons who are referred for mental health treatment actually initiate or complete treatment. Additional adjustments for other potential confounders, such as history of depression or insurance status, could also strengthen the findings. Reducing missing data in medical records is another important area for future improvement.