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  "id": "maternal:idea-perinatal-psychiatry-access-programmes",
  "owner": "maternal",
  "kind": "idea",
  "slug": "idea-perinatal-psychiatry-access-programmes",
  "name": "Psychiatry access lines for obstetric clinicians (MCPAP for Moms model)",
  "aliases": [],
  "atlases": [
    "maternal"
  ],
  "summary_plain": "An idea tested in Massachusetts: give obstetric clinicians access to advice from a perinatal psychiatrist, plus resource and referral help, so they can find and treat mood problems in pregnancy and after birth themselves. Programme data show that clinicians who used it more treated more mood problems, though that does not prove it caused the change.",
  "summary_technical": "The Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms) is designed to increase clinicians' willingness to address perinatal mood disorders. Its encounters are either resource and referral contacts or psychiatric consultations, in which the programme psychiatrist advises the clinician or the patient. In a 2023 analysis of 1,006 clinicians in obstetrics and gynecology, family medicine and pediatrics, using programme data from July 2014 to June 2020, higher use was associated with more treatment of perinatal mood disorders (IRR 1.07, 95% CI 1.06 to 1.07). The analysis is an association in programme data, with no comparison group, and measures clinician behaviour, not women's outcomes (see the claim on this page). An earlier utilisation report on the programme was not used because it appeared in a journal whose content is identity only in this atlas. The recipient is the clinician in the evidence; the women served are the intended beneficiaries.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-14",
  "last_evidence_check": "2026-10-14",
  "next_review_due": null,
  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "pregnancy",
        "postpartum"
      ],
      "care-area": [
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  },
  "payload": {
    "hypothesis": "Giving front-line obstetric clinicians access to a programme psychiatrist's advice and to resource and referral help raises how often they treat perinatal mood disorders.",
    "rationale": "Perinatal mood disorders are common, yet many patients are undertreated (2023 abstract). In programme data, clinicians who used the programme more treated more patients with perinatal mood disorders.",
    "test": "The 2023 analysis is an association in programme data. A comparison with practices that do not use such a programme, and outcomes for women, were not found in the abstract read.",
    "maturity": "early_feasibility",
    "proponents": [],
    "objections": [
      "The analysis read is associational and has no comparison group",
      "It measures clinician behaviour, not whether women were helped",
      "It is one US state's programme; its effect in other health systems is not shown"
    ]
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      "statement": "In a longitudinal analysis of 1,006 clinicians in obstetrics and gynecology, family medicine and pediatrics, using programme data from July 2014 to June 2020, higher use of MCPAP for Moms was associated with higher rates of clinicians treating perinatal mood disorders (incidence rate ratio 1.07, 95% CI 1.06 to 1.07). Psychiatric consultations were associated with more frequent treatment of these disorders than resource and referral encounters, and direct patient consultation was associated with the greatest increase in clinicians treating bipolar disorder (incidence rate ratio 2.12, 95% CI 1.82 to 2.41).",
      "context": {
        "id": "maternal:ctx-mcpap-for-moms-massachusetts",
        "label": "Clinicians using the Massachusetts Child Psychiatry Access Program for Moms (2023 analysis)",
        "recipient": "mixed",
        "population": "Clinicians in obstetrics and gynecology, family medicine and pediatrics enrolled in MCPAP for Moms (1,006 clinicians), and the pregnant and postpartum women they treat. The analysis uses programme data from July 2014 to June 2020. The outcomes are about the clinicians, not about the health of the women.",
        "care_setting": "Practices of obstetrics and gynecology, family medicine and pediatrics (abstract).",
        "geography": "Massachusetts, United States",
        "life_stage_note": "Pregnancy and postpartum (women treated by the clinicians)",
        "life_stage_terms": {
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            "postpartum"
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        },
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "gestational_age_basis": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
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        "postnatal_age_status": null,
        "followup_description": "July 2014 to June 2020 (abstract).",
        "eligibility": {
          "inclusion": [
            "Clinicians in obstetrics and gynecology, family medicine and pediatrics who used the programme"
          ],
          "exclusion": [
            "Not stated in the abstract"
          ]
        }
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      "evidence_stage": "observational",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "Only the PubMed abstract was read. This is an association in programme data, without a randomized or matched comparison, so it does not show that the programme caused clinicians to treat more patients. The outcome is how often clinicians treated, not whether women improved. The programme is one US state's model, and its effects elsewhere are not shown.",
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