Needs Assessment of an In-Patient Unit for Perinatal Mood Disorders at the University of Utah

Background: The perinatal period represents the time before, during, and after having a baby. This is often assumed to be one of the happiest times of a woman's life. However, for nearly 20% of women, this experience is marked by unanticipated emotional turmoil. Perinatal mood disorders have become a leading cause of disability for women. This vulnerable time leaves women highly susceptible to psychiatric disorders such as depression, bipolar disorder, psychosis, and mania. Local Problem: Perinatal mood disorders such as severe depression, mania, and psychosis are psychiatric emergencies, requiring immediate medical attention, treatment, and specialist referrals. The process of admitting and treating perinatal patients at the University of Utah (UU) is lacking in efficiency and promptness. Perinatal mood disorders can be potentially life-threatening, and immediate admission to an in-patient facility to be observed and treated both pharmacologically and non-pharmacologically can greatly improve the prognosis and safety of the patient and her child. The purpose of this needs assessment was to determine the feasibility of an inpatient unit at the UU for perinatal mood disorder patients. Methods: A needs assessment was performed to examine the gap in mental health care experienced by the perinatal population and determine if an in-patient unit at the UU is feasible. This was conducted through the collection of qualitative and quantitative data. Key engagement partners were brought together for a series of collaborative meetings, interviews, and both formal and informal discussions. A SWOT (strengths, weaknesses, opportunities, threats) assessment was conducted during these meetings. Post- surveys were distributed to engagement partners. Analyzed data were compiled into an executive summary and distributed to all key engagement partners. Interventions: Interventions included a collection of data, participating in a series of key engagement partner meetings, post-survey administration, and summarization of information distributed to key engagement partners via executive summary. Results: The results of this needs assessment indicated that 38.5% of the patients being admitted to HMHI, which is a part of the University of Utah (UU) healthcare system, in 2022 were admitted for perinatal mood disorders (n=187). Of those admitted for perinatal mood disorders, 44.4 % of those admissions were for Major Depressive Disorder (n=83). Perinatal mental health patients suffered from not receiving appropriate and timely care. Data from the SWOT analysis showed that there was a desire and drive from all involved key engagement partners to deliver appropriate perinatal mental healthcare, but weaknesses within our perinatal healthcare system must be addressed. Conclusion: Currently, an in-patient unit for perinatal mood disorder patients at the UU alone would not properly satisfy the needs experienced by this vulnerable population. Instead, resources, time, and attention should be directed toward enriching the collaboration, training, and education of UU obstetrician/gynecology (OB/GYN) and psychiatric providers at HMHI. Interdisciplinary team members are needed to bridge the gap in healthcare and reduce the barriers currently experienced by individuals seeking perinatal mental health services.