Perinatal Resource Offering Mood Integrated Services & Evaluation
Pregnancy can be a trying time for many women. The federal Agency for Healthcare Research and Quality estimates that as many as 13 percent of women suffer either major or minor depressive episodes during the often emotionally and physically challenging perinatal period.
The perinatal period
"Perinatal" pertains to the period surrounding the time of birth, from the twentieth week of gestation to the twenty-eighth day of newborn life.
The PROMISE Clinic at University of Colorado Hospital provides on-site screening, treatment and community referrals for women during this stressful time.
Call (720) 848-1060 for appointment information
Meeting an unmet need
The clinic reflects a steadily growing recognition in the medical community that pregnancy and the period after delivery can be difficult times for women, says Cheryl Chessick, MD, assistant professor of Psychiatry and director of the Women’s Studies and Treatment program at UCD’s Depression Center, who helped launch the project.
“Women who are pregnant are often going through a huge role transition," says Chessick.
About 85 women currently receive treatment at the clinic, says Erica Schwartz, CNM, MSN, DNP, director of Midwifery Services at the College of Nursing. "The clinic is a place where patients have a relatiionship with the perinatal providers they trust," she says. "They don't have to go off-site, so the idea of getting psychiatric care is not as daunting."
Watch "one patient's story" below
A team process
Providers screen each patient at the PROMISE Clinic, using two tools.
One probes for depression and thoughts of suicide, the other for bipolar disorder. Those who screen positive get a referral to Chessick, Schwartz or the practice’s OB/ Gyn, Elizabeth Brass, MD, for a firstline interview.
The providers obtain a comprehensive timeline of the patient’s “mood history,” Schwartz says, to identify each patient’s risk factors, such as family history, abuse, limited social support, thyroid problems and other comorbidities.
A small team of providers runs one-hour sessions at the clinic; Chessick provides therapeutic oversight and helps personally with complicated cases.
The clinic also continues to forge relationships with community mental health services and clinics, UCH's Outpatient Psychiatric Practice, The Children's Hospital and other providers so women have continuing access to care.
"We're bulding a system of care," Chessick says. "There's no point in screening patients without that."
This page is adapted from a story that appeared in the UCH Insider, the hospital's candid e-newsletter. The Insider, which is published biweekly, is available to people outside the hospital via a free e-mail subscription. Tyler Smith (firstname.lastname@example.org) is managing editor of the Insider.
One patient's mood disorder story