As perinatal depression has soared during the pandemic, a piece of good news comes from a new Northwestern Medicine study. The study finds that paraprofessionals generated similar reductions in depressive symptoms as mental health professionals when delivering a group-based cognitive-behavioural therapy intervention. The paper will be published in the Archives of Women's Mental Health.
The study findings are based on adding home health visits by trained lay health professionals to low-income pregnant women in a national project called Mothers & Babies. Mothers and Babies is an intervention using cognitive behavioural therapy that aims to reduce stress and improve mood among pregnant women and new mothers.
But since in-person home-visits are no longer possible during the pandemic, the program has recently pivoted to deliver the therapy virtually to pregnant women.
"The response to Mothers and Babies delivered virtually has been incredibly positive from providers and clients," said lead study author Darius Tandon, associate professor of medical social sciences at Northwestern University Feinberg School of Medicine. "In this COVID environment, the need for mental health services is so great that providers and perinatal women who have stress in their lives are really valuing the ability to receive help remotely."
One in five women will develop postpartum depression, and both mother and child are adversely affected by postpartum depression.
"Preventing postpartum depression before it starts is critical in promoting the health and well-being of new mothers and their children," Tandon said.
"With appropriate training and supervision, lay health workers can do a good job," Tandon noted. "We don't have to rely on mental health professionals. We can go another route."
This is the first study to the researchers' knowledge that has used lay home visitors to deliver a postpartum depression preventive intervention. Previous studies using lay health workers have focused on postpartum depression treatment.
Researchers say there is a growing interest in the notion of "task-shifting", or moving care from more specialized (e.g., mental health professionals) to less specialized health workers.
"This study suggests that it is possible to 'task shift' the delivery of interventions aimed at preventing postpartum depression to paraprofessional home visitors, said Tandon, who is also co-director of the Center for Community Health at Feinberg. "This is notable given the lack of available mental health professionals in many communities, as well as the stigma associated with seeing 'formal' mental health providers."
The use of paraprofessional home visitors - rather than costlier mental health professionals -- also may minimize the cost associated with delivering interventions, he noted.