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Abstract

Parents of infants with prolonged neonatal intensive care unit (NICU) hospitalizations are a population that is overlooked in recommended routine screening for perinatal mood and anxiety disorders (PMADs), yet this population is at greater risk for developing diagnosable mental health disorders. Previous research shows that across the US, PMAD screening and treatment practices vary widely, with many NICUs not providing any routine PMAD screening, psychoeducation, or treatment options to parents. The objective of this study was to explore the current mental health screening and treatment protocols used in NICUs across the state of Minnesota to learn if there are areas of alignment or gaps, as well as identify barriers NICU staff face in implementing these practices. A representative knowledgeable about the implementation of PMAD screening and treatment practices, typically a hospital social worker, from each of the NICUs in Minnesota was invited to participate in a quantitative cross-sectional survey. Responses were received from 12 of the 15 NICUs in Minnesota (80%). The results showed that over half of NICUs did not have routine protocols for screening parents of NICU infants for PMADs (n = 7, 58%) and if a parent scores high on the screening tool or reports signs/symptoms of PMADs, less than half (n = 5, 42%) did not or were unsure if they have a protocol for providing treatment recommendations. Half of NICUs used an evidence-based screening tool to screen the mother/birthing parent after birth while the other half did not administer any screening tool. Fathers/the non-birthing parent (n = 4, 33%) and mothers who are hospitalized antepartum (n = 4, 33%) were less often screened for PMADs. While all NICUs provided some form of psychoeducation and mental health treatment referrals/resources to NICU families, only four (33%) offered in-hospital mental health therapeutic services. The most common barrier to implementing routine PMAD screening was insufficient funding for NICU psychosocial staff. The most common barrier to implementing in-hospital mental health therapy was that the “parent is not considered a patient,” although for hospitals that already offer in-hospital therapy, lack of time, insufficient funding, and lack of multidisciplinary collaboration were cited as the greatest barriers. The implications of this study are to inform future research, hospital policies and state policies to ensure parents of NICU infants receive equitable and consistent perinatal mental health care across the state to ultimately mitigate adverse effects associated with untreated PMADs and promote familial wellbeing.

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Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

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