Screening and Treatment for Perinatal Mental Health Disorders

Helping Families. Supporting Communities. Empowering Individuals.

TO: Physicians, Advanced Practice Nurses, Hospitals, Federally Qualified Health Centers, Encounter Rate Clinics, Rural Health Clinics, Certified Health Departments, and School-Based/Linked Centers

RE: Screening and Treatment for Perinatal Mental Health Disorders

Screening and Treatment for Perinatal Mental Health Disorders (pdf)


The purpose of this notice is to provide information about the recently enacted legislation regarding perinatal mental health disorders (effective January 1, 2008) and to provide referral information.

Public Act 95-0469, Perinatal Mental Health Disorders Prevention and Treatment Act

The purpose of PA 95-0469 is to increase awareness and to promote early detection and treatment of perinatal depression. PA 95-0469 can be found at: http://www.hfs.illinois.gov/mch/pa0469.html

The Act requires that:

  • Licensed health care professionals providing prenatal care provide education to women, and if possible and with permission, to their families about perinatal mental health disorders
  • All hospitals providing labor and delivery services provide new mothers, prior to discharge following childbirth, and if possible, provide fathers and other family members complete information about perinatal mental health disorders
  • Licensed health care professionals providing prenatal care, postnatal care, and care to the infant invite the women to complete a questionnaire to assess whether they suffer from perinatal mental health disorders

The Departments of Human Services, Healthcare and Family Services, Public Health, and Financial and Professional Regulation, as well as the Medical Licensing Board will assist providers to develop policy, procedures and educational materials to meet these requirements.

Healthcare and Family Services (HFS)

HFS covers about 51 percent of Illinois births. Providers throughout Illinois have partnered with HFS to address perinatal depression by screening, identifying, referring and providing treatment to HFS-enrolled women. We ask that you become an HFS-enrolled provider, if you are not already enrolled, and provide medical services to HFS-enrolled participants. Information about HFS provider enrollment is available at: http://www.hfs.illinois.gov/enrollment/

Additionally, we also request that you remind women of the importance of receiving their postpartum exam, developing a reproductive health plan, including birth control, and receiving regular preventive care through an annual preventive health visit and family planning visits.

Since HFS' original Informational Notice in 2004 announcing reimbursement for perinatal depression risk assessment, screenings have significantly increased and additional resources have been made available. However, continued progress in screening for perinatal mental health disorders is needed.

Screening for perinatal depression using an approved instrument is a reimbursable service to HFS-enrolled providers for screening HFS-enrolled women. The approved instruments include:

  • Edinburgh Postnatal Depression Scale
  • Beck Depression Inventory
  • Primary Care Evaluation of Mental Disorders Patient Health Questionnaire
  • Postpartum Depression Screening Scale
  • Center for Epidemiologic Studies Depression Scale

Please refer to the HFS Informational Notice, Screening for Perinatal Depression, dated November 30, 2004, for information on reimbursement for by HFS perinatal depression screening and consultation and referral. The notice is available at: www.hfs.illinois.gov/mch/ppd_notice.html

Resources

A wealth of provider and patient-focused information and resources are available at:

Information available on the HFS Web site includes:

  • information and services;
  • perinatal depression risk factors;
  • the Edinburgh Postnatal Depression Scale;
  • consultation and referral resources;
  • support groups;
  • inpatient and outpatient providers; and
  • updated information about medications that may be used in the management of perinatal depression both during and after pregnancy.

The following resources are available to assist in screening, identifying, referring and treating women experiencing perinatal depression.

Perinatal Mental Health Consultation Service

The Perinatal Mental Health Consultation Service is a free consultation service for health care providers who have questions about the detection, diagnosis and treatment of perinatal mental health disorders. Consultants are faculty and staff clinicians from the University of Illinois at Chicago Women's Mental Health Program. Since its inception, the Consultation Service has completed over 700 consultations. We encourage you to take advantage of these expert consultation services, free of charge. Requests can be made via toll-free telephone or on line, and are generally answered within one business day.

Perinatal Mental Health Consultation Service, 1-800-573-6121

Perinatal Antidepressant Medication Chart

The chart summarizes data about risks and benefits of prescription antidepressant medications during pregnancy and breast-feeding. It is based on data from published studies in human pregnancy, and is updated when key new information is published. The most recent chart is attached for your convenience and is also available for free viewing and download on HFS' Web site at: www.hfs.illinois.gov/mch/medchart.html

24-Hour Crisis Hotline

A statewide 24-Hour Crisis Hotline is available for women experiencing perinatal depression. The 24-Hour Crisis Hotline is operated by the Evanston Northwestern Healthcare Perinatal Depression Program. The hotline provides crisis counseling and referral to local mental health services. Please provide the hotline number to women being screened for perinatal depression.

24-Hour Crisis Hotline: 1-866-ENH-MOMS (1-866-364-6667)

Training Opportunities

University of Illinois at Chicago provides trainings on perinatal mood disorders at no cost. The workshops provide basic training for primary and prenatal health care providers on perinatal mood disorder screening, assessment and treatment. Advanced workshops focus on advanced skills building for screening and assessment, pharmacotherapy and mother-infant relationships. Mental health providers will have the opportunity to create regional groups with a special interest/expertise in peripartum depression. Please see the enclosed flyer of workshop titles and objectives.

Workshops can be held on site for clinician groups, and can be tailored to group needs. Workshops can be requested by toll-free telephone or on line:

  • 1-800-573-6121
  • www.psych.uic.edu/research/perinatalmentalhealth

Evanston Northwestern Healthcare (ENH) offers in-service trainings and opportunities, and coordinates with UIC on provider trainings. ENH has developed a referral network for HFS-enrolled women who call the 24-hour crisis hotline.

The Enhancing Developmentally Oriented Primary Care (EDOPC) partnership project also offers office-based trainings at no cost to primary health care providers across Illinois on a wide range of developmental and social/emotional topics, including Perinatal Maternal Depression Effects on Children. For more information on this project, visit www.edopc.org or call the EDOPC Project at 1-888-270-0558.

The Illinois Academy of Family Physicians (IAFP) provides its members and other primary care providers continuing medical education developed for and by primary care providers. A web-based training on perinatal depression is available at: www.iafp.com/education

Perinatal Depression Booklet

The U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) has a free educational booklet available that can be distributed to women in your practice. "Depression During and After Pregnancy: A Resource for Women, Their Families, and Friends" is available by calling the HRSA Information Center at 1-888-Ask-HRSA (1-888-275-4772). The booklet can also be downloaded at: www.mchb.hrsa.gov/pregnancyandbeyond/depression/

For questions regarding the perinatal depression and resources available to providers or clients, please contact:

  • DHS: 1-800- 843-6154
  • DPH, Women's Health-Line at: 1-888-522-1282

For billing related questions related to services provided by HFS-enrolled providers for HFS participants, please contact HFS' Bureau of Comprehensive Health Services at 1-877-782-5565.

Carol L. Adams, Ph.D., Secretary
Illinois Department of Human Services

Barry S. Maram, Director
Illinois Department of Healthcare and Family Services

Damon T. Arnold, M.D., M.P.H., Director
Illinois Department of Public Health