Literature Collection

We compared referrals and connection to care between perinatal patients: 90 receiving OB/GYN care in clinics with integrated behavioral health consultants with infant mental health specialization (IMH-BHC), and 68 receiving traditional care, in the United States. Participants identified as: Native American/Alaskan native, 1.90%; Asian, .63%; African American, 58.23%; Middle Eastern, 6.96%; African National/Caribbean Islander, .63%; Latin-American, 8.86%; and White, 28.48%. Approximately 80% of families in each group were offered referrals. By design, intervention women received mental health services during pregnancy; 16% of women in either group received postpartum mental health services. Intervention group participants were over three times as likely to engage in IMH home visiting. Treatment families were less likely to follow up with infant referrals, but also had fewer infant emergency room visits. All intervention participants met with an IMH-BHC prior to recruitment; however, only 20% self-reported encounters with a mental health professional, indicating these interactions may not be identified by the participants as mental health care; therefore, openness to treatment may be increased for women who feel stigma around mental health care. Given the importance of perinatal mental health, OB/GYN clinics and others serving perinatal patients may consider integrating IMH providers as part of the care team.

INTRODUCTION: Somatic symptom and related disorders (SSRDs) is an umbrella term for physical symptoms related to or amplified by psychosocial factors. Clinicians find difficulty in delivering SSRD diagnoses to families. Caregiver buy-in of an SSRD diagnosis is strongly associated with better outcomes. Curricula addressing gaps in this communication skill are lacking, indicating a need for effective educational innovations to increase pediatricians' confidence and efficacy in SSRD diagnostic conversations with caregivers. METHODS: A 90-minute curriculum composed of didactic and experiential components, including role-play, was designed using Kern's six steps to curriculum development and the INFORM framework (Introduce, Name and Narrate, Feedback, Orient to diagnosis, Reframe, Management principles). We evaluated and improved the curriculum over multiple iterations using the CIPP (Context-Input-Process-Product) model, in which acceptability and feasibility data were collected from participants via quantitative surveys. These surveys also assessed attainment of educational objectives. RESULTS: A total of 85 responses (of 97 total participants; 88%) were obtained from pediatric residents, pediatric hospital medicine fellows, and pediatric hospitalist attendings. Based on survey responses to two of three true/false questions, participants demonstrated significantly improved knowledge postcurriculum. The proportion of learners reporting feeling confident in SSRD diagnostic conversations increased, from 32% before to 86% after the curriculum. A total of 95% of respondents would recommend this curriculum to a colleague, and 98% reported they would use their skills in future clinical practice. DISCUSSION: We created a novel, well-received SSRD diagnostic communication curriculum via an iterative process, with demonstration of achieved educational objectives.

OBJECTIVES: This study sought to understand factors related to weather-related disaster survivors' health information and mental health-care-seeking behaviors. METHODS: In November 2017, we conducted a quantitative survey of 170 Gulf Coast residents who experienced weather-related disasters. The survey assessed how individual and psychosocial factors affect health-care-seeking behavior. RESULTS: Nearly 66% of participants reported a high frequency of depression and/or anxiety symptoms, yet only 39% saw a medical professional. Of participants who visited a medical professional, 76% sought information from nonmedical sources. Seeking medical care was strongly correlated with seeking information from nonmedical sources and previous healthcare experiences, but not with fear and stigma. CONCLUSIONS: Positive communication and strong support systems have the potential to mitigate the reluctance people have in seeking help for mental health problems. Although it is discouraging that few people seek professional care, it is promising that participants were not avoiding care due to fear of being stigmatized. Less opposition to mental health care by survivors offers opportunity for mental health professionals to treat the psychological problems survivors experience. Providing necessary information may make headway to mental health care where it is greatly needed.