The role of clinician assistants in addressing perinatal depression

Abstract

Background

Upwards of one in seven individuals experience perinatal depression and many individuals cannot access treatment. In response, perinatal depression is increasingly being managed in the obstetric setting. This study aimed to characterize the experiences of clinicians and clinician assistants to inform the extent to which clinician assistants can help address depression in obstetric settings.

Methods

This cross-sectional analysis used data from an ongoing cluster randomized control trial: The PRogram In Support of Moms (PRISM). Participants included clinicians (physicians, certified nurse midwives, nurse practitioners) and clinician assistants (medical assistants, nursing assistants). Baseline data regarding practices and attitudes of clinicians and clinician assistants toward addressing depression in the obstetric setting were described. Logistic regressions were used to examine the association of clinician time to complete work and depression management.

Results

Clinician assistants experienced significantly fewer time constraints than did clinicians. However, having adequate time to complete work was not significantly associated with increased depression management in clinicians. Clinician assistants reported feeling that addressing depression is an important part of their job, despite variation in doing so.

Conclusion

Clinician assistants are interacting with perinatal women extensively and are a vital part of obstetric care workflows. Clinician assistants report that they want to address depression and have time to do so. Thus, clinician assistants may be poised to help address the mental health needs of perinatal individuals.

Keywords:

• Perinatal metal health
• health services research
• clinician assistants
• collaborative care
• perinatal depression
• postpartum depression

Disclosure statement

The third and fourth authors have received salary and/or funding support from Massachusetts Department of Mental Health via the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms). The third author is the Engagement Director for MCPAP for Moms and Medical Director of Lifeline4Moms. She has served on Advisory Boards for Sage Therapeutics and is a consultant to Sage Therapeutics and Ovia Health. The fourth author is also the statewide Medical Director of MCPAP for Moms and Executive Director of Lifeline4Moms. The fourth author has served on Advisory Boards for Sage Therapeutics. She has served as a speaker for Sage Therapeutics, a consultant to Sage Therapeutics or their agents, and has served as a consultant to Ovia Health. She has also received honoraria from Miller Medical Communications and Medscape.

Additional information

Funding

This work was supported by Prevention (CDC) through a Cooperative Agreement [Grant number: 1U01DP006093] awarded to the University of Massachusetts Medical School, an award from the UMass Medical School Center for Clinical and Translational Science TL1 Training Program [Grant Number: TL1TR001454], and the UMass Medical School Medical Scientist Training Program (MSTP) [Grant Number: T32GM107000].