Early program development
Prior to opening the Day Hospital (DH), we embarked
upon a process to document the clinical need, practical
feasibility, and fiscal viability of the program. The key
elements of this process were: 1) identifying a clear
rationale; 2) evaluating clinical demand in our area;
and 3) assessing feasibility of the DH by consulting with
members of local stakeholder groups.
Articulating the program’s rationale
In our rationale for the DH, we emphasized three points:
First, we stressed that perinatal psychiatric illness is highly prevalent yet seriously under-treated. Second, we
emphasized the known risks to mother, infant, and family
associated with depression, the most common perinatal
disorder. Third, we reasoned that providing mental health
services within an obstetric setting is advantageous given
that obstetrician-gynecologists or primary care providers
often provide the first or only mental health treatment for
many pregnant and postpartum women. By providing
psychiatric care within the infrastructure of the obstetrical
setting, it would convey to the women who became our
patients that their psychiatric treatment was a component
of their obstetrical experience (pregnancy and=or childbirth).
The actual setting of the Day Hospital program is
on the campus of the main obstetrical hospital but in a
separate building. Although we originally conceptualized
the program as providing care only to postpartum women,
we reasoned that serving pregnant women with depression
and other mental health problems was also essential
given the serious nature of these disorders, and because
early treatment during pregnancy could possibly prevent
the development of more severe postpartum illnesses.
Thus, we defined the program’s mission as serving the
unique needs of women suffering from depression or
other psychiatric disorders during pregnancy or following
childbirth, in a supportive and familiar setting, with a
commitment to providing integrated care to mothers and
their newborn children.
Early program development
Prior to opening the Day Hospital (DH), we embarked
upon a process to document the clinical need, practical
feasibility, and fiscal viability of the program. The key
elements of this process were: 1) identifying a clear
rationale; 2) evaluating clinical demand in our area;
and 3) assessing feasibility of the DH by consulting with
members of local stakeholder groups.
Articulating the program’s rationale
In our rationale for the DH, we emphasized three points:
First, we stressed that perinatal psychiatric illness is highly prevalent yet seriously under-treated. Second, we
emphasized the known risks to mother, infant, and family
associated with depression, the most common perinatal
disorder. Third, we reasoned that providing mental health
services within an obstetric setting is advantageous given
that obstetrician-gynecologists or primary care providers
often provide the first or only mental health treatment for
many pregnant and postpartum women. By providing
psychiatric care within the infrastructure of the obstetrical
setting, it would convey to the women who became our
patients that their psychiatric treatment was a component
of their obstetrical experience (pregnancy and=or childbirth).
The actual setting of the Day Hospital program is
on the campus of the main obstetrical hospital but in a
separate building. Although we originally conceptualized
the program as providing care only to postpartum women,
we reasoned that serving pregnant women with depression
and other mental health problems was also essential
given the serious nature of these disorders, and because
early treatment during pregnancy could possibly prevent
the development of more severe postpartum illnesses.
Thus, we defined the program’s mission as serving the
unique needs of women suffering from depression or
other psychiatric disorders during pregnancy or following
childbirth, in a supportive and familiar setting, with a
commitment to providing integrated care to mothers and
their newborn children.
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