Best Care Practices for Mothers Experiencing Postpartum Depression

For many new mothers, “baby blues” can be a common occurrence lasting up to two weeks after delivery. However, if a mother’s symptoms don’t go away or become more severe, it might be postpartum depression – something 1 in 7 mothers experience. Many cases of postpartum depression in women go unrecognized, but knowing how to identify this condition and connect mothers with the right resources can help increase access to care and get mothers the right help when they need it.

Feel free to jump through the topics of this blog using the table of contents below.

Table of contents
Barriers mothers may encounter when seeking mental health care
How providers can help mothers address their mental health needs
Resources and education opportunities for providers
How Iris Telehealth can help

Barriers mothers may encounter when seeking mental health care

There are many risk factors that can increase chances of postpartum depression, a few of these include: a history of depression and anxiety, lack of support, mothers who carried difficult pregnancies, and mothers of twins. However, it’s important to remember that any person can battle postpartum depression regardless of these risk factors.

Getting mothers the care they need is essential, but gaining this access isn’t always easy. Fortunately, telehealth can help.

Let’s look at a few ways telehealth can help mothers overcome some common challenges they face:

  • Stigma: A study by Frontiers found that as many as 58% of mothers who experience postpartum depression will not reach out for help, with many stating they were to scared to seek help. Whether it’s due to the shame mothers with newborns sometimes feel, or societal stigma, telehealth allows mothers privacy to take their appointments. That way, they don’t have to worry about running into their provider in the community, or someone they know in the waiting room.
  • Social determinants of health: Challenges related to social determinants of health (SDOHs) play a prominent role in keeping mothers from the care they need. Taking time away from their newborns may not be an option for mothers who struggle to find transportation or affordable childcare. Telehealth allows mothers to get the care they need without having to leave their homes. It also connects them to telemental health specialists and postpartum education that may not be available locally.
  • Lack of screening: The American College of Obstetricians and Gynecologists guidelines recommend that mothers receive screening 10-14 days after giving birth to identify and treat postpartum depression. Theses screenings are important because between appointments, it might be difficult for mothers to remember to bring up how they’re feeling. Whether they’re experiencing feelings of hopelessness, discomfort with sharing, or sadness, screenings can help prompt important conversations. Telehealth allows mothers to check in with their providers to address common postpartum concerns before it interferes with their daily life.

Because of the convenience and access to specialty care, telehealth can be an essential resource in providing care and breaking barriers for people experiencing postpartum depression.

How providers can help mothers address their mental health needs

Providers play an integral part in caring for mothers and their mental health. By understanding maternal mental health conditions like postpartum depression, providers can offer quality treatment to mothers going through challenging times.
Here are three ways providers can use to help mothers address postpartum depression and get proper treatment for their mental health:

  1. Addressing stigma: As a provider, addressing stigma related to managing postpartum depression can help mothers feel more comfortable discussing the condition more openly. Opening up the conversation and emphasizing how prevalent postpartum can be can help mothers feel less alone in their experience. It can also help decrease the probabilty that the mother will internalize the struggle and not seek care.
  2. Educating mothers about their options: Postpartum depression is treatable. By getting mothers involved in education ahead of time and letting them know what to look for during pregnancy and after delivery, it can be easier for them to reach out for help from their providers. From a mental health standpoint, having a child can impact the whole family, and providing education and resources along the way can be beneficial for everyone. For example, let mothers know about support groups, hotlines they can reach out to, and organizations like Postpartum Support International (PSI), Health Resource and Services Administration, and other local resources in their community.
  3. Reach out: Remind mothers that they also need to care for themselves. Having a solid support system is necessary to get through the stress of a new baby. A support system could look like a partner, family member, or friend. As a provider, you can help your patients assess their current support system and encourage them to reach out when necessary. Reaching out to the mother’s pediatrician can also help assess how the mother and the baby are feeling.

Resources and education opportunities for providers

There are many resources for providers looking to learn more about maternal mental health care. Clinicians can further improve the care they provide by learning about specific issues that mothers, children, and families face when there is a postpartum diagnosis or risk.

Here are a few resources that can help you provide quality care to mothers:

  • Postpartum International Certificate Trainings: Postpartum Support International has multiple certificate training programs for providers looking to learn skills related to assessing and treating perinatal mood disorders. There are options for small group discussions, supplemental reading, and live sessions for certificates.
  • 2020 Mom Trainings: 2020 Mom, a national maternal mental health non-profit organization, has a series of training that include eight live sessions, small group discussions, supplemental reading materials, 16 continuing education credits, and a certificate of completion.
  • March of Dimes’ Professional Continuing Education: March of Dimes, an organization committed to maternal and child health, has many continuing education opportunities for healthcare providers caring for birthing persons. Certain CMEs include strategies to increase screening during the perinatal period, identifying risk factors and signs for maternal health disorders, and the impact of maternal health disorders on the mother, baby, and family.
  • Postpartum Support International (PSI) Webinar: This webinar talks about the range of maternal mental health disorders. In this 90-minute free webinar, PSI shares information about the prevalence, signs and symptoms, and recommended treatment options.

How Iris Telehealth can help

At Iris, we help organizations implement telehealth into their practice so they can help more people get the mental health care they need. We connect your patients with clinicians who have experience managing postpartum depression. Contact us today to learn how you can implement a telemental health program that can help the families in your community!

Dr. Paul Vance Shares His Advice on Managing Work-life Balance as a Telemental Health Provider

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This month, we’re sitting down to talk with Dr. Paul Vance.

Q. How did you find Iris and decide you wanted to be an Iris provider?

A: I worked in a community mental health center for about a dozen years, and in 2016 I decided to move to the West coast with my family. My daughter just graduated high school. I loved the job I came from, but I didn’t like the job that I went to in Oregon. We’d already purchased a house, and at that point, you’re stuck. I looked around and found Iris. I’d had a great job for about 12 years and then a not-so-great job for 18 months. I didn’t look at Iris as “I hope they hire me.” I looked at Iris instead, asking, “am I going to work there, and will I enjoy it?”

I had a great interview and then looked on the internet about what other providers were saying about Iris, and it was positive. I initially joined Iris thinking I would do it until I found something else I liked, but I rapidly fell in love with Iris and haven’t looked elsewhere.

Q. How does telepsychiatry compare to in-person work?

A: I’m working at a community mental health center in Mississippi, and before, I worked at a community mental health center in person. The jobs are very similar to each other. The difference is, safety-wise, my wife is a lot happier where I’m working now. In 12 years, I’d taken a gun from a patient who pointed one at me, a box cutter, and a set of knives. I did a lot of state hospital step-downs and court-ordered treatment, and many times people weren’t very happy with you when you’re doing that. I don’t have that problem now. I don’t have to worry about someone following me home or knowing where my kids are going to grade school.

That’s a big difference. It’s just simply safer from that point of view. The other part that’s different from it is you have a lot more time. I walk into work at 8:50 or 8:55. Before it would’ve been 8:15, I would’ve left the house. I probably wouldn’t have gone to the gym before work because it was too long to drive. Then you have to shower. Time-wise, you may work the same number of hours, but you save several hours per day just simply not doing the stuff you did when driving someplace. As far as working with nurses and patients, you all forget that you’re on a computer. I send pictures to the nurses of my dogs. They send me pictures of their kids. It goes back and forth. It’s about the same as what it is when you work in an office.

Q. How do you foster connection with patients virtually?

A: I think fostering a connection virtually is easier. That may be due to the patient load I like treating. I like treating people with severe mental illnesses like schizophrenia and severe bipolar disorder. These patients are often more comfortable because you’re not in the room. They like the idea that they’re by themselves. You’re not going to see them in the community. I was quite surprised by that. But, often, it’s just simply easier, and that goes for patients without severe mental illness, too. Quite a few patients are more comfortable talking to you when you’re not there rather than if you’re actually in the room with them.

That means sometimes giving you personal information they might be more uncomfortable giving. For example, I think it’s easier for someone to say, “I do methamphetamines” and “I drank a lot of alcohol,” if you’re not there. I think it’s surprising for me. At first, I thought it would be difficult to connect, and it’s actually far easier.

Q. As a healthcare professional, how do you manage work-life balance?

A: I helped lead a lot of other physicians when I worked at the community mental health center. One thing is you have to have interests that don’t have anything to do with being a physician. I’ve been married for a long time. We have a freezer full of mushrooms that we pick from the woods. We do a lot of gardening. We forage for plants. We hike our dogs. We’ve coached soccer, cross country, and track. I’ve helped a couple of teams win state championships. It’s more about having an interest that you’re simply interested in. That way, when you finish work, you don’t sit down and veg out but are excited to do something else. That’s part of it.

And then the other part I’ve seen this with virtual physicians and then in-person physicians is, if you’re not organized, if you don’t finish your notes quickly, and practice writing notes well, what happens is you’ll see many physicians spend several hours after they finish work on notes. That doesn’t have anything to do with the computer, but that drains you.

I always make sure my notes are done before taking a break at lunch. Before I finish work at the end of the day, I’m done. And usually, if the work shift ends at five o’clock, I’m walking out the door by 5:05. Organization comes with it.
The last one is what I always tell patients. You should treat yourself as well as you treat your dog. Feed it well. Walk it every day. Get it up on time. Make it go to bed on time. Just live a healthy life, which helps you have an outside interest.

Q. What is the most rewarding part of your job?

A: I like seeing people get better. When I entered medicine, I figured out pretty quickly that a lot of the specialties I simply did not want to do because they were focused on treating disease. I see people with severe mental illness, but that’s just a part of who they are. My big focus is I want you to live a healthier life. I want you to be better with your kids. I want you to be better with your community. I want you to get out and move. And when you see patients do that, to me, that’s the most rewarding part.

Q. What do you love about working with Iris?

A: Iris is pretty responsive. That was kind of scary at first because I could say, “Hey, I’m having an issue,” and somebody would call me within about three minutes. I wasn’t used to that. They’re interested in ensuring you’re happy, the clinic is happy, and everything is running smoothly. I was used to working in the community mental health center, where you have to throw a fit to get your computer fixed. That hasn’t happened with Iris. It just simply happens. I say, “I’ve got a problem,” and they fix it.

Q. Why do you think telepsychiatry is important to the future of mental healthcare?

A: It’s already happened that way for the most part. If you’re in a rural community or live in an inner city, you will only get mental health care if you have a psychiatrist that’s being remoted in. I work in two towns in northern Mississippi, and their nearest physician is in Memphis. I think it’s an hour and a half away. They’re not going to do that. Many people don’t have cars; if they do, they can’t make an hour and a half drive. I grew up in a small town of 1,500. We never had a physician in the town. You never went to the doctor because the nearest physician was an hour away, and I grew up on a farm. That didn’t happen. Everybody’s moving to the cities, and those inner cities will need care, and telemedicine is the only way it will be provided. Then the rural communities are the same. For the people who are deciding to stay there, telemedicine is the only way they’re going to get care.

Q. What advice would you give to someone new to telepsychiatry?

A: The big advice I would give is very practical. I have three screens. I look at the patient on one screen, and I have a second screen off to the left and a third screen off to the right. That’s the smallest advice you could give, but having an adequate screen, a keyboard that works, a mouse that you know, where it is, and having your printer where you can reach it, are crucial. I’ve talked to one other psychiatrist doing virtual, and I could see them looking at me because they were close to the screen, which meant I knew they had a small screen. That doesn’t work. The best thing is to organize your workspace, which is different from seeing a patient in person.

I wouldn’t even have the screen if I saw a patient in person. I wouldn’t even have a computer or a keyboard sitting in front of them. That part’s different. Office organization is the most important thing. Then, the other which I did with both sites is do whatever you need to do to have the site you’re working with allow you to access their medical record before you start working. Those two are practical.

On the flip side, it’s far easier to be organized in telepsychiatry than in person. You don’t have charts that you’re fooling around with. When you close the record out, it’s closed. That part makes it easy. You can take notes on the desk on the paper beside you if you need to. That part is easier, but it’s really not good if you’re not organized.

Q. What are some benefits you’ve found from working remotely?

A: I entered the relationship with Iris reluctantly. I was looking desperately to keep my house and still be able to work and not move. The only thing I would’ve done differently is I would’ve probably looked for Iris several years earlier. I can’t believe the lifestyle change in a very positive way. I hike every single day. I missed one day the last year in the national forest.

I moved from Oregon to Kentucky while working for Iris. Four years ago, when I moved from Kentucky to Oregon, I had to change jobs. I had to make sure all kinds of things were just done. When I moved from Oregon to Kentucky, I was still employed with Iris. It was simply a matter of taking a week’s vacation and plugging myself into a new room. That was such a lifesaver. It was unreal as far as timewise, money, and everything else. We may move again, but it’s easy when you’re not changing work.

At Iris, we believe our providers should be respected, valued, and applauded for the work they do, and we couldn’t be more proud to say, “thank you” to our very own Dr. Vance. If you’d like to learn more about working for Iris Telehealth, contact us today.

How Bridge Care Services Helps Fill Short-Term Care Gaps to Ensure Effective Patient Care

Meeting behavioral health patients with timely support, appropriate care, and proper follow-up is essential to their care journeys. Unfortunately, finding the right care isn’t always easy. Between provider shortages, increased demand for mental health treatment, and social determinants of health, patients may spend a lot of time waiting for care without ever receiving the support they need.

Thankfully, Bridge Care Services can help. Keep reading to learn more about how bridge care can help connect patients with the right provider in a timely manner, so their care can be as effective as possible.

Table of contents
Bridge care 101
How Bridge Care Services works
The benefits of Bridge Care Services
Where Iris Telehealth fits in

Bridge care 101

A dedicated bridge care program can help support health systems via a virtual bridge clinic that deploys a measurement-based model to fill short-term gaps in behavioral health care across the continuum. It can also help patients with a behavioral health referral get timely, high-quality care and appropriate treatment and follow-up.

Keys to success:

  1. Augmenting behavioral health access: Any system struggling with its referral volumes needs a mechanism to augment its clinical bandwidth to reduce its backlog – whether that means optimizing existing resources or leveraging a third-party partner like Iris Telehealth.
  2. Financial sustainability: Health systems have to maintain financial viability for any program to stand the test of time. A bridge care program should be designed accordingly and optimized for reimbursement.
  3. Care navigation: Clinical recommendations that direct the patient to the right type of care, from the right type of provider.

Additionally, by leveraging telehealth for a bridge care program, organizations are better positioned to help their entire population, including those who live in hard-to-reach areas or those who might be dealing with transportation barriers.

How Bridge Care Services works

There are four components that make up Bridge Care Services and help more people get the care they need.

Here’s how those components work to support health systems:

  • Care pods: A care pod is a team-based approach to care that enables collaboration between social workers, therapists, psychiatric mental health nurse practitioners, and
    psychiatrists to ensure they can work together towards the best possible care for their patients. This teamwork allows the clinicians to share their expertise when needed and work together when managing a patient’s behavioral health care.
  • Navigation assessments: A navigation assessment walks a patient through their journey to ensure they get where they need to go. This process looks at the patient’s needs through focused, biopsychosocial, and evidence-based questions. Based on the assessment, the patient is quickly triaged to the appropriate level of care.
  • Short-term care: Effective short term care requires dedicated providers who can deliver appropriate care to patients for approximately 90 days following the initial assessment. By working with a telehealth solution that is technology-neutral and can integrate into an organization’s patient outreach process, healthcare organizations can seamlessly ensure patients receive the short term behavioral health care they need.
  • Closed loop hand-off: Effective bridge care ensures the facilitation of a seamless patient handoff from short-term care back to their PCP or community behavioral health provider for appropriate ongoing treatment. This facilitation helps set up both the patient and the health system for appropriate long-term success and helps prevent patients from falling through future behavioral health gaps.

For a more in-depth look at how Bridge Care Services works, download our whitepaper.

The benefits of Bridge Care Services

With the immense need for care, health systems are overwhelmed. Thankfully, Bridge Care Services can help organizations with the influx they’re experiencing, provide additional support, and continue providing the highest quality of care they’re accustomed to delivering to their patients.

When implemented properly in a health system, Bridge Care Services can help:

  • Support organizational quality measures
  • Increase patient satisfaction
  • Decrease provider burnout
  • Retain patients within the health system
  • Keep patients in the referral queue out of the ED
  • Support attainment of HEDIS measures
  • Reduce 30-day readmission rates
  • Promote referring provider satisfaction

Bridge Care Services helps provide a transformative process for health systems, their teams, and the patients they serve.

Where Iris Telehealth fits in

At Iris Telehealth, we believe patients deserve access to high-quality behavioral health care. That’s why we walk with them throughout their care journeys to help ensure they get the most effective care possible. If you’d like to learn more about our Bridge Care Services program, contact us today or download our whitepaper.

The Benefits of Telemental Health and Building Rapport Virtually

Providing a virtual behavioral health solution for your patients can offer many benefits to your organization. Telehealth provides access to many treatment techniques that translate well to a virtual platform and treat a broad range of speciality mental health conditions.

Keep reading to learn the benefits of telehealth for specific populations, how providers build rapport virtually, and different ways providers are using telehealth to increase engagement during appointments.

Table of Contents
The unique benefits of telemental health
How to build rapport through telepsychiatry
How providers facilitate specialty care remotely
Where Iris Telehealth fits in

The unique benefits of telemental health

Because of telehealth’s expansive reach into communities with few providers, patients have access to specialty treatment and care they otherwise wouldn’t be able to access.

Let’s take a look at three other unique benefits of telehealth for mental health care:

  1. Condition-specific treatment: Providing a virtual option for care delivery, either in your clinic or from a patient’s home, can open up care to people who may experience nervousness traveling, patients with agoraphobia, or someone with general anxiety about meeting a new person in a new place. Allowing someone to take their appointment from a place where they’re familiar can help them feel more comfortable and assist in establishing rapport. Telehealth can also help patients with trauma feel more comfortable processing and disclosing information.
  2. Increased privacy for patients: Meeting in a private location can help patients feel more comfortable and less worried about running into people they know in the waiting room or their providers in the community. This great sense of privacy can help patients feel more comfortable and allow them to engage and feel more at ease during their sessions.
  3. Traditional psychotherapy capabilities: For the traditional therapeutic encounters that happen within the office setting, telehealth providers can conduct them just as well via telepsychiatry as they would in person. Delivering remote care isn’t a barrier to establishing therapeutic rapport, providing medication management, or providing traditional psychotherapies.

When considering implementing a virtual behavioral health solution, it’s important to note that the typical diagnoses that translate well to telehealth are with patients with who you can easily engage individually or as a family system.

How to build rapport through telepsychiatry

Building rapport with patients is essential to implementing a virtual behavioral health solution. Even though society has primarily adjusted to telehealth during the pandemic, it’s important not to assume that patients have engaged with telehealth before or prefer telehealth over in-person.

To help determine how a patient feels about telehealth, you can check in with them, ask how they feel, and learn whether or not telehealth is their first choice. You can also ask them what they think are the negatives and positives about the platform. Sometimes, the patient might decide they want to do in-person care. Regardless of their preference, it’s essential to be open and honest to understand how the patient feels.

Another critical piece of building rapport is educating the patient on the parameters of a virtual appointment. For example, even though the appointment is not being held in an office setting, the patient should still be in a secure place and communicate their location to the provider. Some patients may have questions about where the provider is located and whether or not their door is shut. Transparency is important, especially since the patient and provider can’t see each other’s space.

How providers facilitate specialty care remotely

Telehealth is the great connector between people and the specialty care they need. This platform opens up the pool of providers with specialty expertise patients otherwise wouldn’t be able to access. Without specialty care, patients may experience delayed and ineffective treatment, the risk of worsening symptoms, and the need for a higher level of care. Accessing specialty care remotely allows patients to get the right care and make the treatment gains they need to feel better.

Therapists leverage telehealth creatively to help engage patients and provide their needed treatment. For example, some providers working with children will draw with the patient, play games, and have show and tells. Therapists will also provide homework and worksheets.

One of our LCSWs here at Iris Telehealth, Nicole Bradbury, spoke about her experience providing care virtually to her patients:

“There are a lot of different benefits to telepsychiatry. For one, I love finding new ways to engage with the kids. I’ve found websites where I can interact with them virtually, like “Let’s play Uno and talk about feelings!” It’s fun to find new ways to explore engaging with the children, especially the younger ones.”

Where Iris Telehealth fits in

Our team of psychiatrists, PMHNPs, and LCSWs, work with your care team to provide holistic, specialty care to your population. If you’d like to learn more about how we can help reach more people in your community with specialty care, contact us today.