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The Dimock Center Leads the way in the integration of mental health care with obstetric care

9/15/2013, noon
Over the past two years, The Dimock Center in Roxbury has been one of the leading community centers in the ...
(L-R): A Dimock Center patient with Dr. Nandini Sengupta, The Dimock Center’s medical director. Dimock Center

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Over the past two years, The Dimock Center in Roxbury has been one of the leading community centers in the country in efforts to integrate behavioral health with pediatrics. Spearheading this effort is Dr. Nandini Sengupta, Dimock’s medical director of Health Services, who also serves as the director of the Behavioral Health Pediatrics Integration Program. Of the program, she says, “We’re really one of the few practices doing it right now. We have a team of primary care staff and mental health clinicians plus a psychiatrist sitting in the same space, co-managing the patient at the same time. We’re bringing that model into OB-GYN.”

Beginning this fall, The Dimock Center is expanding the integration of mental health care and obstetric care for all women who receive prenatal services at Dimock. The focus is on early detection and treatment of depression in pregnancy.

Sengupta, who has been practicing at Dimock for almost 20 years, says this program came about when “one of our social workers gave a general talk to a group of pregnant women in our Centering Pregnancy program (group prenatal visits for women who are at the same gestational age), about signs and symptoms of depression and was overwhelmed by their response.” She added, “That’s when we realized the huge unmet need.”

The Dimock Center was recently awarded a grant in the amount of $10,000 by the Community Partnership Fund through Children’s Hospital. The funding will pay for a Licensed Social Worker (LICSW) to be on site four days a week, adjacent to the clinic at all initial obstetric appointments.

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Dimock Center

(L-R): Dr. Nandini Sengupta, medical director, and Dr. Holly Oh, The Dimock Center’s chief medical officer.

Typically, all women at their initial prenatal care appointment are required to fill out a Patient Health Questionnaire Nine (PHQ9) form. The form contains nine questions to screen for depression, and if a patient screens positive, she often has to go elsewhere for treatment due to limited resources. With this recent funding, women who score positive on the PHQ9 will have the support of the LICSW on site for focused individual counseling in tandem with prenatal care visits. Offering this service in a familiar setting not only improves access to behavioral health care but also helps to reduce the stigma associated with mental health visits.

Projecting based on previous years’ data, about 160 pregnant women ages 16-43 will receive prenatal care at Dimock between September 2013 and October 2014. One hundred and thirty of them will deliver while in the Center’s OB-GYN practice and 120 of them will bring their infants to Dimock for pediatric care.

The goals of the program are to increase early detection of depression in pregnancy, to improve pregnancy and infant health outcomes as a result of identifying and treating depression in pregnancy and to improve staff and patient satisfaction with an integrated mental health and obstetric care model.

Additional mental health and psychiatrist appointments will be offered as needed. Those who need case management around mental health care, support with obtaining pharmacy benefits and transportation to appointments will be assisted by case managers co-located in the OB-GYN clinic and funded partially through the Boston Healthy Start Initiative (BHSI).

Dr. Holly Oh, chief medical officer of The Dimock Center and a practicing pediatrician, believes that the holistic approach to pediatrics and mental health “is about taking care of the whole patient.” She adds, “We believe it is therapeutically better care for the patient, and the convenience is significant. In the integrated pediatric program, we have seen improved access to behavioral health care, reduction in no-show rates, and improved satisfaction with care, both from the patient and staff perspectives. With this new program, we anticipate similar outcomes in our OB clinic.”

Recognized nationally as a model for the delivery of comprehensive health and human services in an urban community, The Dimock Center provides the residents of Boston with convenient access to high quality health care and human services.

For more information on The Dimock Center and its programs, visit www.dimock.org.