making social work A review of social services

making social work A review of social services available to perinatal patients at St. David’s Medical Center in Austin, Texas Jennifer Sandler, LCSW-S

Objectives • • Review social work role Review criteria for social work involvement Review community outreach efforts and available resources Provide patient examples

About Me • Jennifer Sandler • Licensed Clinical Social Worker • Women’s Services Social Worker at St. David’s Medical Center for 7 years

St. David’s Medical Center • Located in central Austin • 350 bed acute care hospital • In 2019: 3, 375 deliveries (3, 007 nursery, 368 NICU) • 24/7 Perinatal Social Work staffing • Weekdays: 2 dedicated SW (1 NSY, 1 NICU) • Weekends: 1 dedicated SW (NSY & NICU) • Nights: fulltime, part time & PRN SW for ED and women’s

My Role • Mental Health Assessment & Intervention • • PMAD Prevention & Psychoeducation Counseling Support families/loved ones Safety Assessments Needs Assessments Advocacy Resource referrals

Policy: Social Work Consult Guidelines • • • Mental Health concerns/history/crisis Overwhelmed, emotional Lack of preparedness for baby Bonding Homelessness, housing instability Financial stressors Community resource referrals Abuse and neglect, CPS Substance use/abuse Domestic Violence Human Trafficking Recent immigration to US • • • Teen parents Bonding Adoption Surrogacy Fetal demise & miscarriage New HIV positive Untreated health issues Situational stressors Recent/current incarceration Long term antepartum admissions All families with a baby in the NICU Access to medications/medical care

National Association of Perinatal Social Workers www. napsw. com • NAPSW Code of Ethics • Standards for SW role in: • Adolescent pregnancy • Adoptions • Postpartum Depression • NICU • Obstetric Settings • Perinatal Bereavement • Surrogacy

Community Partners & Assistance with Basic Needs • Cribs • • Car Seats Baby Baskets Clothes Diapers Formula Taxi vouchers, Lyft, bus passes Medication Assistance (antibiotics) Cafeteria Vouchers

Other Local Organizations & Helpful Connections • Trainings: • UT Austin Perinatal Mental Health Conference • Black Mama’s Community Collective • www. blackmamasatx. com • Central Texas Perinatal Coalition • www. centraltexasperinatal. org • Pregnancy & Postpartum Health Alliance of Texas • www. pphatx. org • Community Clinic Social Workers • Social Work Interns • Medicaid • Safe Riders • www. dshs. texas. gov/saferiders • Postpartum Support International • www. postpartum. net • The Periscope Project • www. the-periscope-project. org • Mother to Baby • www. mothertobaby. org

Finding Resources In Your Community • Aunt Bertha website (www. auntbertha. com) • 2 -1 -1

Resource Packets & Handouts ● ● ● ● English & Spanish Perinatal Mood & Anxiety Disorders Community Resource Guide Housing, shelter, homelessness Perinatal loss Substance use & abuse …. and more!

Patient Examples

Example 1 • Patient: : 24 years old, C-section, twin boys! • Social Work Consult Requested For: verbal abuse, separated from the babies’ father • Additional Needs/Concerns Identified by Social Worker: • baby supplies • stress • sadness & grief • Social Worker Provided: • supportive counseling • Postpartum depression education/information • donations: 2 cribs, diapers, formula • Outcome: • • patient was relieved, appreciative, plan for counseling aware of Postpartum depression symptoms & treatment options supplies and safe sleep space for babies

Example 2 • Patient: : 29 years old, C-section delivery, baby girl • SW Consult Requested For: history of Postpartum Depression • Additional Needs/Concerns Identified by SW: • did not have all supplies for babies • not living in an appropriate environment • depressed since 2 -year-old daughter was born • Social Worker Provided: • supportive counseling • Postpartum Depression education/information • donations: car seat, baby basket, clothes, diapers, formula, community resources • Outcome: • Patient found a different relative to live with • Patient to seek counseling and restart Zoloft • Patient reported feeling better after talking and making plans

Example 3 • Patient: 37 years old, C-section, baby girl • • Social Work Consult Requested For: Schizoaffective Disorder Additional Needs/Concerns Identified by Social Worker: • psychosis: talks to angels, demons and spirits; thought FOB was possessed by a demon and feared that BG would be too determination made that it was unsafe for the patient to be alone with her baby • • SW Provided: • thorough assessment, in-depth collection of information from collaterals • supportive counseling to patient, significant other, family • telehealth psychiatry consultation • coordination of transfer to inpatient psychiatric hospital • Close coordination with CPS • donations: baby basket, diapers, formula • Outcome: • Patient was transferred to an inpatient psychiatric hospital • Baby girl was discharged to patient’s father

Questions? Feedback? jennifer. sandler@stdavids. com