On August 15, 2011, UNC’s newly renovated Perinatal Mood Disorders Inpatient Unit admitted its first patient.
To those of us who have followed maternal mental health for decades, this is cause for great celebration. The significance of a specialized, well-equipped in-patient unit staffed by experienced and dedicated professionals represents an unprecedented milestone in the response to both the acuity and needs of mothers who develop these concerning, but highly treatable mood disorders during or after pregnancy.
Samantha Meltzer-Brody, MD, MPH the new center’s director, spoke about the clinical and programmatic road to this seminal moment. She noted that specialty services for women needing in-patient treatment for perinatal mood disorders have long been lacking. “Often”, states Dr. Meltzer-Brody, “they had been dissatisfied with psychiatric inpatient experiences which offered no specialized maternal services or appropriate facilities for their needs, especially to receive infant visits. We had initially attempted to house mothers needing inpatient treatment in our geropsychiatry unit as an interim solution. Before we could open a dedicated facility, we needed to demonstrate that a specialized in-patient unit would be fiscally viable.”
Throughout the past few years, Dr. Meltzer-Brody and her staff were treating rising numbers of mothers in their renown outpatient program. With increasing patient populations and a staff including experienced practitioners like Chris Raines RN, who possess the clinical expertise to evaluate and determine the specialized therapies and services needed, the time seemed right to move forward with their dream facility.
Says Ms. Raines, “Our goal is to empower women and help them begin to understand this disorder and decrease the stigma surrounding depression and anxiety. By providing a caring and compassionate environment with providers who understand what helps and what does not help, we hope to give these women and their families the ability to heal and possibly grow through the difficulties of these disorders”.
In addition to compelling data and patient feedback overwhelmingly indicating the need for this comprehensive in-patient unit, Dr. Melzer-Brody is quick to credit a pro-women’s mental health initiative among the leadership at UNC as a major factor in the center’s development. Dr. David Rubinow, Director, UNC Center for Women’s Mood Disorders helped to spearhead and maintain the support needed among UNC administrators, who have endorsed and whole-heartedly support this new facility.
The growing level of national interest in this issue - which has now found its way into state and federal law - also contributed to the impetus in finally generating a comprehensive medical/psychiatric facility. The creation of UNC’s Perinatal Psychiatry In-patient Unit offers a national model for replication in every state. UNC can be very proud of taking the lead in this ground breaking achievement for maternal mental health!
The new unit has its own entrance and is completely free-standing. The treatment team is comprised of highly trained doctors, nurses, psychologists, midwives, social workers, and other therapists who work together to create individualized treatment plans. Included is comprehensive assessment and treatment, medication stabilization when needed and a vast range of individual and group therapies as appropriate.
Dr. Melzer Brody echoed that caution is required to avoid inadvertent implication that might stigmatize any individual woman’s mental health issue. It is patient acuity and needed services which ultimately determine in-patient placement. For example, a woman suffering from the extremely rare postpartum psychosis would initially be admitted to the unit which treats psychosis. Once stabilized, she would then be able to participate in the perinatal psychiatry in patient unit’s programs.
With five dedicated beds (two of which can be partitioned to another unit if needed, the new perinatal psychiatry unit offers the following services:
• Protected sleep times
• Extended visiting hours to maximize positive mother-baby interaction
• Gliders for pumping and nursing in patient rooms
• Hospital-grade breast pumps, refrigeration and freezer storage
• Lactation consultants
• Specialty trained nursing and other staff
• Group therapies including art, relaxation, behavioral, and psycho-education
• Biofeedback therapy
• Mother-infant attachment therapy
• Family and partner assisted interpersonal psychotherapy
• Therapeutic yoga geared for pregnancy and postpartum women
• Nutrition consultation
• Obstetrics and Gynecology Consultation
• Spiritual support from hospital chaplains with expertise in the perinatal period
• Discharge planning and transition to outpatient either in the UNC Perinatal Psychiatry Outpatient program or in the patient's community
Dr. Melzer-Brody’s hope is that “other facilities/hospitals around the country will be inspired to open dedicated in-patient perinatal psychiatry programs within their own institutions”. Her wish is certainly one echoed by all of us who support and serve new mothers and understand the need to balance an inpatient stay with easy access to the mother’s infant and other postnatal support services.
I am looking forward to attending the Grand Opening Ceremony of this facility which will be held on September 15, 2011, but it is already operational. Congratulations to Dr. Melzer-Brody and her associates for their perseverance in the creation of this much needed haven. To find out more about the program, please click here.