Kelly Devine Arch is a mother, nurse, and certified nurse-midwife, and wants expectant mothers to know it’s okay to ask for help with their mental health.
Devine Arch is enrolled in the University of Colorado College of Nursing at Anschutz Medical Campus’ DNP (Doctor of Nursing Practice) Program and is working on earning a Psychiatric Mental Health Nurse Practitioner post-graduate certificate. She graduated from the college’s Nurse Midwifery (CNM) Program and now works at the University of Colorado Center for Midwifery in Longmont.
“Many mothers may hesitate to discuss mental health concerns with their providers, fearing they could be perceived as incapable or face judgment, adding to the apprehension of admitting they can't do it all,” she says. “Moms need to recognize that seeking help is not a sign of defeat, but rather a courageous step towards acknowledging the common challenges during pregnancy or the postpartum period. By fostering an open dialogue, we aim to reassure mothers that they are not alone in their struggles, encouraging them to share their experiences and seek the support they deserve."
Devine Arch is working on a project through the DNP Program to boost mental health support and resources. The project implements several new processes at the University of Colorado Center for Midwifery in Longmont to improve the clinic’s ability to identify patients in need of mental health services through referrals, as well as ensuring proper follow-up care.
The clinic has a tool to guide healthcare providers in identifying, managing, and following up with patients who need a mental health screener or who disclose related concerns. It has also undertaken initiatives to enhance the comfort and knowledge of obstetrical providers in the care of patients with mental health disorders.
“We are actively working to dismantle the stigmatization of mental health within our clinic by fostering open discussions and emphasizing to our patients that mental health is an integral aspect of maternal health,” she says. “Through these combined efforts, we aim to create a supportive environment that prioritizes mental health, ensuring comprehensive care for our patients.”
A significant aspect of the clinic’s efforts involves establishing and nurturing community partnerships and community outreach. By doing this, they hope to strengthen the support network and raise awareness about mental health within the community. Devine Arch says these efforts complement the clinic’s internal strategies while working towards a more comprehensive and accessible mental health care system for their patients.
“The most common preventable obstetrical complication in the perinatal period are mood and anxiety disorders,” she says. “One in five people in the perinatal population have a perinatal mood or anxiety disorder.”
“I wanted to do this project because I feel like obstetrical providers are in a very unique position to help bridge the gap between mental health care and obstetrical care,” she adds. “We see patients so often, so we can kind of see how they’re doing mental health-wise.”
She says the Longmont Midwifery Clinic has already been screening women for mental health disorders, she says women had trouble getting treatment because they couldn’t find providers who would accept their insurance, couldn’t afford care, or faced other barriers.
The project is designed around the most current practice guidelines set forth by the American College of Obstetricians and Gynecologists (ACOG).
“When you become a mom for the first time, there’s all kinds of transitions, and I enjoy being that stable, calm, supportive person they can rely on and trust,” she says. “I’ll answer their questions and try to support them in the best way that I can.”
Giving Patients More Resources
The clinic is focusing on creating community partnerships for referral sites and expanding patient resources. The project aims to streamline the referral process for providers by furnishing essential information on mental health providers, including details on insurance acceptance and the availability of services in languages such as Spanish, thereby facilitating easier and more informed referrals.
“Our goal is that we are helping patients establish care,” she says. “The hope is that this project is creating a well-rounded program so that people aren’t slipping through the cracks. Sometimes our Medicaid or VA patients have long wait times to get help so the hope is that we can provide that extra support while we continue to help them establish care.”
The clinic has been using Devine Arch’s ideas since September.
“It’s incredible because we’ve been following up with people and they are showing improvement over time,” she says. “We’ve also received feedback from patients who say they felt really supported.”
Devine Arch is the team leader of the project but says its success is due to the commitment and hard work of her colleagues at the clinic.
“Implementing substantial changes in their practice can be challenging for providers, yet our team has demonstrated remarkable dedication and persistence throughout the course of this project.”
What’s Next?
Devine Arch will graduate from the DNP Program in May and will earn a PMHNP post-graduate certificate this fall. The hope is to eventually implement an integrative care model at the Longmont Midwifery Clinic so people can get both obstetrical care and mental health care under one roof.
“If someone comes to our clinic for a prenatal visit and they’re struggling, we want to be able to say ‘Someone is just down the hall and can provide you with the support you need’,” she says. “It would be an ideal situation, and research shows that it’s a beneficial model of care.”
