Title: Improving parental mental health in the neonatal intensive care unit through screening for post-traumatic stress symptoms
Abstract:
Problem: Approximately one-third of parents with infants admitted to Neonatal Intensive Care Units (NICU) endorse posttraumatic stress symptoms (PSS) as an effect of the experience. In a Level IIIB NICU in the United States approximately 25% of parents are assessed in person to evaluate their mental health needs. Staff observations of parents revealed signs of stress, tension, irritability, poor sleep, avoidance, and feelings of guilt, shame, and blame. Assessment of the organization revealed that mental health screening for parents was lacking, and one social worker (SW) was designated to evaluate the needs of 200-300 NICU parents annually while covering three additional maternal-child health units.
Purpose: A quality improvement project (QI) was implemented to identify parents experiencing PSS due to the NICU experience using a valid and reliable screening measure and to provide resources or refer them to mental health services.
Methods: In consultation with key stakeholders, the project lead (PL) identified a valid and reliable screening measure, the Impact of Events Scale-Revised (IES-R), and eligible parents, integrated the screening into SW consultations and NICU visitation, established incentives, and methods of communication. QR codes, visual aids, educational materials, and mental health resources were generated to support parent participation and the mental health of approximately 100 parents over 15 weeks.
Results: About 48% of mothers and 20% of fathers completed the screening after their infant's length of stay reached 7 days. Of those, 30% endorsed clinically significant PSS. Twenty-five percent received a mental health consultation and 75% declined. Information on PTSD, perinatal mental health resources, and community mental health providers was provided to all eligible parents.
Conclusion: Considerations for future clinical endeavors to enhance the effectiveness of a routine parental mental health screening and referral process in the NICU will be discussed.
