title: Integrating Maternal Mental Health Care in the Pediatric Medical Home: Treatment Engagement and Child Outcomes.
abstract: Maternal depression is associated with an array of poor child health outcomes, and low-income women face many barriers to accessing treatment. In this pilot study, we assessed treatment engagement in a maternal mental health clinic staffed by a case manager and psychiatrist in an urban pediatric practice. We also examined factors associated with engagement as well as child health outcomes and health care use. Nearly half of the women enrolled attended at least 4 sessions with a psychiatrist in 6 months. Text messaging with the case manager was associated with a greater compliance with psychiatrist sessions. Comparing index children with their siblings prior to enrollment, a higher percentage had immunizations up to date at 1 year of age (82% vs 43%, P = .01), and well-child visit compliance trended toward significance (65% vs 35%, P = .06). The pediatric setting holds promise as an innovative venue to deliver maternal mental health care.
authors.affiliation: 1 Johns Hopkins School of Medicine, Baltimore, MD, USA.|2 University of North Carolina-Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Kimmel
authors.affiliation: 1 Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Rheanna E
authors.initials: RE
authors.lastname: Platt
authors.affiliation: 3 Duke University, Durham, NC, USA.
authors.forename: Danielle N
authors.initials: DN
authors.lastname: Steinberg
authors.affiliation: 4 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.|5 Geisel School of Medicine, Hanover, NH, USA.
authors.forename: Fallon
authors.initials: F
authors.lastname: Cluxton-Keller
authors.affiliation: 1 Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Osborne
authors.affiliation: 1 Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Carter
authors.affiliation: 1 Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Payne
authors.affiliation: 1 Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Barry S
authors.initials: BS
authors.lastname: Solomon
mesh_terms: D000328:Adult; D000067576:Child Health / Q000706:statistics & numerical data*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D008427:Maternal Health Services; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000379:methods*; D010372:Pediatrics / Q000379:methods*; D010865:Pilot Projects; D014505:Urban Population
keywords: case management; integrated; maternal depression; pediatric medical home