Perinatal Adjustment Support Group Jen Bordin Maria Calvachi

Perinatal Adjustment Support Group Jen Bordin, Maria Calvachi, Peggy Gerritsen, Andrew Ssawe Michael Garron Hospital, Flemingdon Health Centre, Health Access Thorncliffe Park, South Riverdale CHC Problem Statement Charts Lack of awareness and timely access to mental health support for pre and post-natal clients living in Thorncliffe Park and Flemingdon Park. The Process Map below indicates service delivery pathways. Enablers Aim Statement To pilot a psychoeducational support group for up to 10 women who are residents of Thorncliffe Park and Flemingdon Park and who have a positive score of 9+ using the Edinburgh Postnatal Depression Scale. Participation in the psychoeducation group will result in increased satisfaction with community post-partum services (90%) and self-reported improvements around coping skills, awareness and intensity/duration of post partum symptoms, resulting in a lower score when compared to the initial Edinburgh Postnatal Depression Scale. Intervention/Change Ideas • Pilot an 8 week psychoeducation support program. • Recruit and train peer educators from the local community to support with outreach and health promotion activities • Deliver trainings for service providers in Flemingdon and Thorncliffe Park to promote best practices in screening for post partum mood disorders • Centralize referral pathways from Michael Garron Hospital, Flemingdon Health Centre and Health Access Thorncliffe Park and Toronto Public Health. Measures Process: Number of staff/peers trained Number of clients reached Number of referrals received to the group Outcome: Self reported improvement in management of symptoms (use of Edinburg Postnatal Depression Scale) Balancing: Increase in referrals for 1: 1 support (exceeds capacity). Challenges to implementation 1. Stigma around mental health- belief that if mental health issue are identified and disclosed to mental health providers, children may be at risk of being removed from their families. 2. Pilot was scheduled to start between February and March 2019 - the cold weather impacted attendance and opportunity for outreach. 3. Cultural practices and traditions posed possible barrier for connecting with new mothers during periods of vulnerability. For example, team recognized that special consideration was needed for addressing cultural practices of not going outside the home for the first 40 days after giving birth. 4. Language and literacy are barriers – holding group sessions is difficult because of language diversity within the community. We will continue to explore ways for meeting the language needs of program participants through the use of language specific groups and/or use of interpretation supports. Sustainability The psychoeducation support group is planned to launch in Spring-Summer 2019. An important element of the project’s sustainability plan are the collaborative partnerships that have been established to date, including those with, Toronto Public Health, Sunnybrook Hospital and Mount Sinai Hospital. In addition, as a result of support from the Toronto Central LHIN for this initiative, a comprehensive evaluation framework and measurement plan is in progress and will inform the roll out of the program in Spring. Summer 2019. Spread Perinatal Adjustment Support Group (PASG) is a pilot project that builds on a highly successful collaborative of East Toronto’s Perinatal Adjustment Program (ETPAP) which engages middle income, white women. Our PASG is unique – we work with low income immigrant women of racialized backgrounds. PASG pilots the use of EPDS, with a dose of cultural sensitivity, to measure program impact. • Collaboration with Michael Garron Hospital, Sunnybrook Hospital and Mount Sinai- support with referrals from hospital to community services and support with referrals to specialized psychiatric services • Partnership with Toronto Public Health and South Riverdale Community Health Centre, these organizations are already supporting the existing East Toronto Perinatal Adjustment Program • Initiative is co-led by Health Access Thorncliffe Park and Flemingdon Health Centre, two of the local organizations in the community providing primary care services in Flemingdon Park and Thorncliffe Park. Next Steps/ Lessons Learned We experienced a delay in recruitment of participants suitable for a group psychoeducation program. As a result, the project team developed a mental health promotion strategy and approach. This resulted in staff working closely with community peer educators who planned and implemented community workshops focused on increasing awareness and understanding of post-partum mood disorders, combined with an opportunity to increase awareness of local community resources. The learning that resulted from this initiative is that focusing on education and increasing the profile of postpartum mood disorders is an important first step in building dialogue and discourse around post partum mood disorders. Contact Name: Maria Calvachi Title: Manager, Primary Health Care Organization: Flemingdon Health Centre Email: mcalvachi@fhc-chc. com Phone: 416 -429 -4991