1. Illinois’ Initiatives in Perinatal Depression Ralph Schubert, M.Sc., M.S. Acting Associate Director for Family Health Illinois Department of Human Services June 29, 2005

2. Task Force Recommendations Patient information Patient information Train MCH providers to screen and refer Train MCH providers to screen and refer Medication guidelines Medication guidelines Develop a full array of treatment Develop a full array of treatment – Prevention, early intervention, case management, social support, psychotherapy Financing Financing

3. Illinois’ Initiatives Public Health Response Public Health Response – Chicago Healthy Start Initiative – Training MCH providers – Patient brochure – Referral resources Resources for Physicians Resources for Physicians – Medicaid reimbursement – Medication guidelines – Consultation – Community referral system

4. Chicago Healthy Start Initiative Screening, assessment and treatment required component Screening, assessment and treatment required component Use Edinburgh Postnatal Depression Scale Use Edinburgh Postnatal Depression Scale Mental health clinician (M.S. or M.S.W.) on staff Mental health clinician (M.S. or M.S.W.) on staff FQHCs provide therapy “in house” FQHCs provide therapy “in house” Referral arrangements Referral arrangements

5. Training MCH Providers Satellite broadcasts Satellite broadcasts – February 2002, Maternal and Postpartum Depression: How to Recognize it and Access Help in the Community Setting – November 2004, Perinatal Depression: Beyond the Blues Overview of the condition, risk factors, signs and symptoms, treatment, billing Overview of the condition, risk factors, signs and symptoms, treatment, billing www.chtc.org - follow links to past satellite conferences www.chtc.org - follow links to past satellite conferences

6. Medicaid Reimbursement Edinburgh Postnatal Depression Inventory or Beck Depression Inventory Edinburgh Postnatal Depression Inventory or Beck Depression Inventory Maternal screening can be billed as a service provided for the woman or her infant Maternal screening can be billed as a service provided for the woman or her infant

7. Medication Guidelines Task Force recommendation Task Force recommendation Developed with Dr. Laura Miller, University Illinois at Chicago, Department of Psychiatry Developed with Dr. Laura Miller, University Illinois at Chicago, Department of Psychiatry Distributed to Illinois members: Distributed to Illinois members: – American College of Obstetricians and Gynecologists (ACOG) – American Academy of Pediatrics (AAP) – American Academy of Family Physicians (AAFP)

8. MCHB Grant University of Illinois at Chicago University of Illinois at Chicago – School of Medicine, Department of Psychiatry Regional workshops on screening, assessment, and treatment Regional workshops on screening, assessment, and treatment – 30 presentations, 1,014 participants – Participants become regional resources Physician consultation line Physician consultation line Public education Public education

9. Lessons & Challenges Collaboration! Collaboration! – Most of this done with existing resources – Many private initiatives Remaining challenges Remaining challenges – Financing the full array of services, especially for Medicaid-eligible women – Bilingual providers – Access to services in rural areas

10. More Information Illinois Department of Public Aid www.dpaillinois.com/mch Illinois Department of Public Aid www.dpaillinois.com/mch www.dpaillinois.com/mch Chicago Healthy Start Initiative www.dhs.state.il.us/chp/ofh/MIH/HealthySt art.asp Chicago Healthy Start Initiative www.dhs.state.il.us/chp/ofh/MIH/HealthySt art.asp www.dhs.state.il.us/chp/ofh/MIH/HealthySt art.asp www.dhs.state.il.us/chp/ofh/MIH/HealthySt art.asp University of Illinois at Chicago – HRSA Perinatal Depression Project www.psych.uic.edu/clinical/HRSA/perinatal.htm University of Illinois at Chicago – HRSA Perinatal Depression Project www.psych.uic.edu/clinical/HRSA/perinatal.htm www.psych.uic.edu/clinical/HRSA/perinatal.htm www.psych.uic.edu/clinical/HRSA/perinatal.htm