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Bridging the Gap for Perinatal Veterans: Care by Mental Health Providers at the Veterans Health Administration.

Kroll-Desrosiers AR, Crawford SL, Moore Simas TA, Clark MA, Mattocks KM. Bridging the Gap for Perinatal Veterans: Care by Mental Health Providers at the Veterans Health Administration. Women's health issues : official publication of the Jacobs Institute of Women's Health. 2019 May 1; 29(3):274-282.

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BACKGROUND: Pregnant women veterans receive maternity care from community obstetricians but continue to receive mental health care within the Veterans Health Administration (VHA). Our objective was to explore the experiences of VHA mental health providers with pregnant and postpartum veterans. METHODS: Mental health providers (n  =  33) were identified at 14 VHA facilities across the United States. Semistructured interviews were conducted over the phone to learn about provider experiences with perinatal women veterans and their perceptions of depression screening and mental health treatment management for pregnant and postpartum veterans receiving mental health care within the VHA system. FINDINGS: Providers identified an absence of screening protocols and referral procedures and variability in risk/benefit conversations surrounding psychotropic medication use as important areas of weakness for VHA mental health care during the perinatal period. Care coordination within facilities, primarily through Primary Care-Mental Health Integration teams, was identified as a main facilitator to promoting better mental health care for perinatal veterans. CONCLUSIONS: Mental health providers caring for veterans during the perinatal period identified several areas where care could be improved, notably in screening and referral processes. A refinement to current guidelines to specify standard screening tools, screening schedules, and referral processes could potentially engage a greater number of pregnant women in VHA mental health care.

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