Study Overview
People who experience severe medical complications during pregnancy or childbirth are at risk for mental health difficulties during the first postpartum year.
The aim of the The MHAP Study is to better understand:
- The personal, family, and life circumstances of people who develop severe pregnancy complications.
- How levels of stress, mood, anxiety, health and quality of life change over the first year postpartum year.
- How people who experience severe pregnancy complications engage with a collaborative mental healthcare program that includes online screening, assessment and evidence-based services to support mental health recovery.
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Perinatal mental health disorders typically refer to mental health difficulties that are present during pregnancy and up to one year following birth. These can include pre-existing mental health conditions such as depression, anxiety, obsessive-compulsive disorder, bipolar disorder, or schizophrenia, but also include mental health difficulties that occur for the first time during pregnancy and the first year after delivery, such as prenatal or postpartum depression, anxiety, and post-traumatic stress disorder related to pregnancy, labour, or delivery.
Research shows that 1 in 5 individuals will experience perinatal mental health disorders and, during the COVID-19 pandemic, the rate has increased further to approximately 1 in 3. The consequences of undiagnosed or untreated perinatal mental health disorders can be serious, leading to more complications in pregnancy such as preterm birth or low birthweight, and can impact the short- and long-term physical and mental health for parents and children. Still, many individuals who are experiencing symptoms of perinatal mental health disorders may not know who to ask for help, or may have difficulty identifying and/or accessing evidence-based psychological care.
When a pregnancy becomes medically complicated, it is normal to experience an increase in stress and distress. How a person copes with a medically complicated pregnancy will depend on whether they have pre-existing mental health diagnoses and on the impact of the pregnancy or birth complication, but also on how much support they have from a partner or friends and family members and their broader life circumstances.
Severe pregnancy complications are known to be a risk factor for perinatal mental health disorders, but the mental health impact of these conditions are not routinely addressed as part of follow-up care. In this study, we aim to see that change.
The MHAP Study research team is hoping to learn more about the psychological, social, and life circumstances of individuals who experience severe pregnancy complications, and to understand more about how mental health changes across the first postpartum year.
We also want to see whether people who experience severe pregnancy complications engage with a collaborative mental health care program to help with some of the short- and long-term mental health impact of these complications. This care includes a comprehensive psychosocial assessment, a debrief session, screening for mental health difficulties during the first year after delivery, and access to individual, evidence-based psychological services for those who want additional support with the mental health aspects of their recovery. We also aim to identify resources that are in our participant’s community, if applicable.
What is involved?
Study participants will be offered collaborative care managed by a psychologist that can include other healthcare providers as needed, and access to individual, evidence-based psychological care delivered virtually up to the first 12-months postpartum.
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Collaborative care is an integrated model of care that treats mental health alongside physical health, with the goal of normalizing mental health problems and reducing stigma while increasing access to evidence-based psychological care. These models also identify and incorporate other sources of care or support as needed, including more specialized services such as consultation with a psychiatrist, social worker, nurse, or obstetrician/gynecologist, and provide information on community resources available to help with recovery after severe pregnancy complications. The overarching goal of this study is to better understand and support the mental health consequences of severe pregnancy complications, recognizing that emotional and physical aspects contribute equally to short- and long-term recovery.
There are four parts of collaborative care that have been incorporated into The MHAP Study:
- screening for mental health problems;
- comprehensive assessment of personal, family, and social/life circumstances to identify areas that could benefit from support or intervention;
- education on self-management and resources; and
- providing psychological services and more specialized support or services, as needed.
Participants of The MHAP Study will be asked to complete:
- A comprehensive psychosocial assessment (1 hour) and online questionnaires about life circumstances, mental health, sleep, and quality of life (30 to 45 minutes).
- A follow-up, debrief appointment with the study psychologist (50 minutes) to discuss the assessment, to receive education on self-management and resources available to support emotional health and recovery, and to collaboratively decide on a follow-up plan.
- An online survey asking you questions related to your mood, levels of stress, and anxiety, once a month, for 11-months (7 to 10 minutes) so that we can track mental health difficulties and reach out to those who are experiencing increased distress.
Broadly, we will be able to gain an in depth understanding of the psychological and social circumstances surrounding severe pregnancy complications and how they change across the first postpartum year.
More specifically, results from The MHAP Study will help us determine: (1) if we can identify and recruit individuals who experience severe pregnancy complications from labour and delivery and/or high-risk follow-up clinics; (2) whether potential participants will attend a comprehensive (virtual) psychosocial assessment and one debrief session; (3) how many participants experience significant symptoms of depression, anxiety, and post-traumatic stress during the first year after a severe pregnancy complication, and; (4) how many participants require follow-up psychological services and/or additional support.