Perinatal depression is one of the most common complications of pregnancy, but limited access to mental health services in rural areas, especially those with underserved populations, prevents women from receiving appropriate care. Collaboration between academic institutions and safety net providers can bring effective mental health services to underserved communities through telepsychiatry. To date, telepsychiatry programs have proven successful in diverse populations, but few specific perinatal depression programs now exist. The present study examines the feasibility of collaboration among an academic institution, a federally qualified health center, and a local health department to implement a telepsychiatry program for pregnant women experiencing perinatal depression.
This study used literature review and in-depth structured interviews with members of the health care community who had experience as a provider or administrator in the delivery of perinatal care, mental health care, and/or telemedicine programs.
Triangulation of data revealed that financial feasibility including physician reimbursement and cost of equipment and network, as well as provider/workforce capacity, are major barriers to implementation. The paucity of Spanish-speaking psychiatrists, and legal questions of licensing and credentialing are other barriers. Facilitators include any pre-existing relationships among these institutions and numerous opportunities for public and private grant funding.
Existing partnerships between academic and community institutions provide a solid foundation from which to expand mental health services to rural communities. Despite partners’ marked willingness to collaborate, they must work to overcome financial, legal, and cultural barriers before we can expect a proliferation of perinatal telepsychiatry programs for underserved populations.