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Psychiatry access lines for obstetric clinicians (MCPAP for Moms model)

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.

  • Idea
  • In this atlas

Overview

Technical summary

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.

Hypothesis

Hypothesis, not a result. Nothing here has been demonstrated.

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.

Maturity
Early feasibility
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.
Proposed 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.

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

Claims and evidence

Context Clinicians using the Massachusetts Child Psychiatry Access Program for Moms (2023 analysis)

Recipient
Mixed recipients
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
Pregnancy and postpartum (women treated by the clinicians)
Gestational age
Not reported
Postnatal age
Not reported
Follow-up
July 2014 to June 2020 (abstract).
Eligibility: 1 inclusion criterion; 1 exclusion criterion
Included
  • Clinicians in obstetrics and gynecology, family medicine and pediatrics who used the programme
Excluded
  • Not stated in the abstract

  • Effect Observational Certainty not assessed

    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).

    Applies to Mixed recipients
    • 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.
    • Practices of obstetrics and gynecology, family medicine and pediatrics (abstract).
    • Massachusetts, United States
    • Pregnancy and postpartum (women treated by the clinicians)
    • Gestational age Not reported
    • Postnatal age Not reported
    Follow-up July 2014 to June 2020 (abstract).
    Certainty method
    Not assessed
    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.
    Last checked
    2026-10-14
    Next evidence check due
    Not scheduled
    Sources and citations (6)

    1. Supports Improving front-line clinician capacity to address depression and bipolar disorder among perinatal individuals: a longitudinal analysis of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms

      Publication · Archives of women's mental health · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2023-05-16 · DOI: 10.1007/s00737-023-01324-1 · PMID: 37188798 · PMCID: PMC10185457

      Locator
      Abstract, sentence 5
      How it applies
      The participants.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      16dc608110d2125b22c3a213bc1d335066e9c2f23db0da87ac0e688f159205c1
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    2. Supports Improving front-line clinician capacity to address depression and bipolar disorder among perinatal individuals: a longitudinal analysis of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms

      Publication · Archives of women's mental health · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2023-05-16 · DOI: 10.1007/s00737-023-01324-1 · PMID: 37188798 · PMCID: PMC10185457

      Locator
      Abstract, sentence 4
      How it applies
      Analysis period.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      16dc608110d2125b22c3a213bc1d335066e9c2f23db0da87ac0e688f159205c1
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    3. Supports Improving front-line clinician capacity to address depression and bipolar disorder among perinatal individuals: a longitudinal analysis of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms

      Publication · Archives of women's mental health · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2023-05-16 · DOI: 10.1007/s00737-023-01324-1 · PMID: 37188798 · PMCID: PMC10185457

      Locator
      Abstract, sentence 8
      How it applies
      Association between utilization and treatment rates.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      16dc608110d2125b22c3a213bc1d335066e9c2f23db0da87ac0e688f159205c1
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    4. Supports Improving front-line clinician capacity to address depression and bipolar disorder among perinatal individuals: a longitudinal analysis of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms

      Publication · Archives of women's mental health · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2023-05-16 · DOI: 10.1007/s00737-023-01324-1 · PMID: 37188798 · PMCID: PMC10185457

      Locator
      Abstract, sentence 9
      How it applies
      Psychiatric consultations versus resource and referral encounters.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      16dc608110d2125b22c3a213bc1d335066e9c2f23db0da87ac0e688f159205c1
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    5. Supports Improving front-line clinician capacity to address depression and bipolar disorder among perinatal individuals: a longitudinal analysis of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms

      Publication · Archives of women's mental health · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2023-05-16 · DOI: 10.1007/s00737-023-01324-1 · PMID: 37188798 · PMCID: PMC10185457

      Locator
      Abstract, sentence 10
      How it applies
      Bipolar disorder result.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      16dc608110d2125b22c3a213bc1d335066e9c2f23db0da87ac0e688f159205c1
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    6. Background Improving front-line clinician capacity to address depression and bipolar disorder among perinatal individuals: a longitudinal analysis of the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms

      Publication · Archives of women's mental health · Edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. · Published 2023-05-16 · DOI: 10.1007/s00737-023-01324-1 · PMID: 37188798 · PMCID: PMC10185457

      Locator
      Abstract, sentence 12
      How it applies
      Authors' conclusion.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      16dc608110d2125b22c3a213bc1d335066e9c2f23db0da87ac0e688f159205c1
      Reuse basis
      PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

Record details

Record id
maternal:idea-perinatal-psychiatry-access-programmes
Content hash
5f9d8560a793c534949a7451a230983dede84aa4d31a73e9d9aacb6a7fb12d6f