Nearly 17% of California’s pregnant and postpartum women suffer from depression, anxiety, or other severe illness such as bipolar disorder. Most of these perinatal mood and anxiety disorders (PMADs) are undetected and untreated, in part because of challenges related to screening, referral, and physician access to expert consultation.

A number of mechanisms have been developed to support psychiatrists caring for perinatal women with PMADs. This paper looks at a pilot test of one initiative in Los Angeles County, the Reproductive Psychiatric eConsult Pilot Project. The goal: to increase capacity of psychiatrists with the Los Angeles County Department of Mental Health to provide medication management to women with severe PMADs.

The project included conducting in-person trainings on reproductive psychiatry and launching an electronic consultation (eConsult) portal specifically for psychiatrists’ questions regarding mental health care management for perinatal patients.

The Takeaway

Although psychiatrists actively participated in trainings and changed practice accordingly (see Figure 1), they were reluctant to use the eConsult platform itself. One policy proposal emerging from these findings is the use of technologies that are familiar to psychiatrists, such as phone or email, to provide access to expert support in managing perinatal women, while using an eConsult-type system to record documentation and facilitate communication across health systems.

Read the full issue brief for a detailed discussion of findings.

About the Authors

Emily C. Dossett, MD, MTS, is a reproductive psychiatrist and serves as the assistant medical director for Women’s Health and Reproductive Psychiatry for the Los Angeles County Department of Mental Health. She founded and directs the Women’s Mental Health Program, a collaborative effort that integrates mental health care into prenatal care clinics.

Christopher Benitez, MD, is an associate medical director with the Los Angeles County Department of Mental Health. He directs psychiatric training programs, oversees eConsult activities for DMH, and works clinically at Olive View-UCLA Medical Center and the San Fernando Mental Health Clinic.

Natalia Garcia, MPH, is director of community resilience at the nonprofit Para Los Niños, where she oversees an initiative to address and reduce the impact of trauma among residents and school communities in Los Angeles County District 1.