Abstract for: Optimizing Postpartum Depression Screening Systems in the Neonatal Intensive Care Unit and Pediatric Emergency Department

Perinatal Mood and Anxiety disorders (PMAD) are a large group of disorders that encompass postpartum depression, anxiety, acute stress disorder, perinatal psychosis, obsessive-compulsive disorder, and post-traumatic stress disorder. PPD, occurring within the first year after childbirth, affects 13-15% of mothers globally, posing a significant obstetric complication and a prominent factor in maternal suicide. Its impact extends beyond mothers to encompass all caregivers, affecting children with higher rates of anxiety, depression, and behavioral issues. Particularly vulnerable are caregivers of infants in neonatal intensive care units (NICU), where PPD prevalence is markedly higher around 39-45%, leading to recurrent visits to the pediatric emergency department (PED). Despite its pervasive impact, clinical recognition, and treatment of PPD in these settings remain challenging. At Children’s National Hospital in 2021, internal benchmarking data shows that only 64% (n=577) of eligible NICU parents and 34% (n=1270) of eligible PED parents are screened even with an established PMAD team of social workers and screeners. To address these complexities, a system dynamics Group Model Building (GMB) approach is employed to analyze the current screening system and develop a simulation model aimed at enhancing screening and referral processes in NICU and PED settings.