Exploring Challenges of Perinatal Mental Health Care
Project Overview
Perinatal mental health conditions (such as postpartum depression and anxiety) are common yet underdiagnosed, and collaborative care models can help close gaps. Our team was tasked with designing a tool to support communication, care coordination, and emotional support for both patients and clinicians. Patients often experienced fragmented care, while clinicians struggled with differing care priorities and limited visibility into each other’s work. The tool needed to address both patient vulnerability and clinician workflow inefficiencies.
My Role
The Team
My responsibilities for this project included:
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Coding and analyzing qualitative data
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Discussing and iterating the themes with the research team
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Developing a journey map
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Collaborating with a medical provider to validate the findings
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Proposing design solutions based on the findings
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Writing up and presenting the findings​
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Tools Used: Dedoose, Miro
I worked with a wonderful cross-functional team:
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Shefali Haldar, Ph.D., Merck & Co., Inc
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Novia Wong, University of California, Irvine
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David Mohr, Ph.D., Northwestern University
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Madhu Reddy, Ph.D., University of California, Irvine
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Emily Miller, M.D., Northwestern University
Research Process and Approach
We wanted to answer two main questions:
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What's it like for patients getting mental health services through the program?
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What difficulties do patients and providers in the CCP run into when getting or giving mental health services?
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To get these answers, we used a two-part approach: talking to patients and observing/interviewing providers. We made sure everything was approved by the Institutional Review Board (IRB) first.
Part 1: Hearing from Patients
We conducted phone interviews with 20 pregnant and postpartum patients from the CCP. We chose phone calls because it's easier for busy parents – no need to worry about a tidy room for video or finding childcare during the call. Interviews usually lasted about 45-60 minutes and covered things like their relationships with CCP providers, feedback on services, and how they managed their mental health day-to-day. We asked questions like, "How has the CCP met, or not met your expectations?" and "What do you wish the CCP could do differently, and why?" Everyone who participated got paid for their time, and we transcribed all the audio recordings.
Part 2: Observing and Interviewing Providers
We also spent time with 10 key CCP providers and care managers, doing both "contextual inquiries" (basically, observing them at work) and interviews. During these sessions, we took tons of notes, asked questions for clarity, and even snapped photos of their daily tasks, how they made decisions, how they used technology, and how they talked to other providers. We observed and interviewed care managers, psychiatrists, psychologists, therapists, an OB/GYN nurse practitioner, a midwife, and an OB/GYN physician. We asked them things like, "What do you consider before referring a patient to another provider?" and "What do you wish could be better about your collaborations with other providers?"
Understanding the Data
To make sense of all the interview transcripts and observation notes, we used a process called "inductive, open-coding". This means our research team started by finding common themes, then independently coded more transcripts, and met regularly to discuss, define new codes, and iron out any disagreements until we had a final set of codes. After that, we created "journey maps" and sorted the information in Miro to get a full picture of everyone's experiences and highlight their shared and unique challenges.
Key Insights
Our study shined a light on several key issues when it comes to teamwork in perinatal mental health CCPs:​​
Hard to Spot and Talk About Symptoms
Many patients didn't know much about perinatal mental health symptoms, and the stigma around mental health made it tough for them to admit what they were feeling or share it honestly with their doctors. This meant getting help often happened later than it should.
Different Ideas About What's Urgent
OB doctors and care managers sometimes had different opinions on how quickly a patient needed mental health support. OB doctors might see a patient in distress but not have the time or specialized knowledge to handle serious psychiatric issues, leading care managers to treat every referral as urgent, which piled onto their already full plates. This rush could also clash with a patient's own decision-making process about treatment, making things unclear for OB providers.
Conflicting Opinions and Unclear Roles
Even though providers worked closely and used communication tools, OB and psychosocial providers sometimes disagreed on treatment plans or weren't sure who was responsible for what, especially with medication and long-term follow-up after the OB care ended. This meant patients got mixed messages and sometimes faced delays in getting the care they needed.
Tracking Symptoms and Progress
Care managers had a tough time making sense of all the electronic screening responses because their tools were clunky. This meant they had less time to reach out to patients who showed concerning symptoms, sometimes even missing urgent cases. Patients also stopped filling out these surveys because the questions didn't quite fit their experience, they felt overwhelmed, or they didn't see the point since they weren't getting actionable feedback.
Getting Ready to Leave the CCP
When patients transitioned out of the CCP, they often struggled to connect with new therapists or find ones their insurance would cover. The CCP usually didn't know about these issues, leaving patients without the continued support they needed.
My Recommendations
Based on what we found, I suggest some ways technology could help patients and providers improve CCP experiences.
Smooth Out Provider Conflicts
We can use existing electronic health records (EHRs) to help OB and mental health providers make treatment decisions together. This could involve:
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"Care Priorities" section where each clinician can flag what they see as critical. For example, OB flags “preterm labor risk,” psychiatrist flags “severe sleep disturbance.”
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A chronological view of patient touchpoints (appointments, screenings, medication changes, major updates) so clinicians remain aware of all points of care and to highlight when care is fragmented.
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Shared visual tools that track a patient's symptoms, so all types of providers can see how their treatment plans are affecting the patient's physical and mental health journeys.​
Fill Support Gaps
Let's create platforms that can support patients as their physical and mental health needs change through different pregnancies and different stages of pregnancy. These platforms should:
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Let patients ask questions and get reliable answers from both OB and mental health providers who know their personal history.
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Allow patients to customize what information they see (like symptoms of postpartum depression or new medication research) to avoid getting lost in a "rabbit hole" of overwhelming online info.
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Help first-time parents connect with experienced parents for emotional support.
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Give care managers and mental health providers a continuous way to stay in touch with patients, even after the OB care ends, reducing the need for constant phone calls and helping catch issues during transitions.
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Be able to flag urgent patient needs and "assign" follow-ups to the right providers, making roles clearer.
Ultimately, these tools should always keep the patient's experience at the center and help push for better mental health and well-being for parents.
Lessons Learned
This project taught me some really important things:
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Even when patients want to advocate for themselves, making complicated treatment decisions can be overwhelming. We need to make it easier for them to get clear, consistent guidance from their care team.
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The stigma around mental health, plus patients not wanting to "bother" their doctors or even admitting their own feelings, really affects whether symptoms are caught early and if treatment is accepted. Technology needs to be designed with these emotional hurdles in mind.
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Even with good collaborative care models, there are still system-level issues like the mental health journey lasting longer than the OB journey, and providers not always knowing who's responsible for what. Technology can be a huge help in connecting these dots and ensuring continuous care.
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While automation can make things more efficient (like tracking symptoms), it's crucial not to lose the human touch and personal connection that are so important for good mental health care.