Mammha: A Digital Tool That Helps Clinicians Screen For Perinatal Mental Health Issues
Kat Marriott • April 14, 2023
Understanding the needs of your targeted audience is a key step in advancing the path for an innovative digital health care start up. And for one of HITLAB’s Breakthrough Alliance Challenge winners, gaining a better understanding of the needs of their audience was just what they needed. Mammha founder and CEP Maureen Fura knew that Ob/Gyns were screening women for perinatal mental health issues, such as postpartum depression, and needed a tool to help them improve their screening rates, but how was it going to actually change their practices? Through the HITLAB BTA Challenge program, Mammha received a small research project designed by HITLAB’s research team in conjunction with the start-up.
Mammha’s mission is to improve the screening practices of clinicians treating women during their most vulnerable stage of life, motherhood. A woman may receive the most medical attention in her whole life during pregnancy. However, screening for a mother’s mental health often slips through the fingers of many providers. For many mothers, having a baby comes with a roller coaster of hormonal changes that can trigger anxiety and depression. Although the providers often treat the physical symptoms of pregnancy, such as morning sickness or body aches, they often fail to acknowledge the stress and isolation that can arise during pregnancy. After seeing a plethora of providers and failing to find a solution, Maureen Fura created Mammha with the goal of becoming a system-wide solution to screen pregnant women and support them in all stages of their pregnancy.
Evidence from national studies indicate that although effective treatment options are available and increasingly accessible via telehealth, perinatal mental health (PMH) concerns, including postpartum depression (PPD), remain underrecognized and undertreated due in part to a lack of widespread screening by healthcare providers. Furthermore, low rates of screening are attributed to health care provider’s lack of time, knowledge around screening, as well as unfamiliarity with resources for referral. Importantly, healthcare providers report feeling overwhelmed by the responsibility of staying up to date with screening and referrals for PMH issues. Only 15% of women who screen positive for a maternal mental health complication access appropriate care and less than 20% of clinicians screen for maternal mental health issues. Fura knew that Ob/Gyns are caring and compassionate individuals and want to provide appropriate care to their patients. So, what could be preventing them from screening more women and getting them the treatment that they need?
With the assistance of Senior Research Manager Dr. Kat Marriott, HITLAB conducted a user narrative analysis and surveyed clinicians about their practices and perceptions of the PMH screening process prior to and after having access to the Mammha platform. The simple digital platform delivers the EPDS screening survey for perinatal mental health concerns to their patients through their cell phone, scores the survey, and immediately connects those needing care with resources in their area, as well as a care coordinator to help them navigate the process. The platform also simultaneously relays the survey results back to the clinician. The simplicity of the system takes the heavy burden of assisting their patients in an area that they are not qualified for nor trained to deliver – mental healthcare.
Clinicians know the importance of screening for depression and anxiety, but overwhelming articulated that they are not prepared for the next steps. Comments like “if you came with a positive screening, now you have the paper in front of you, and you have this huge Pandora’s box, because then the patient would start telling you exactly what happened and you have to go through a lot of counseling in one sitting with the patients when unfortunately, we are not equipped for that. We’re OB-GYNs and we are not in a setting of therapists or a psychiatrist that has an hour with a patient and that is prepared to manage that. You are a general OB-GYN trying to identify issues.”
With the implementation of the Mammha digital screening platform, clinicians experienced a notable increase in the frequency of screening from “sometimes if I had a concern” to “all of the time”. There was also a notable shift in the category of screened patients. Prior to using the platform, most clinicians indicated that they were screening postpartum patients only, with some screening both pre and postpartum. With the platform, most clinicians indicated that they were now screening ALL of their patients, regardless of their maternal status. This notable sift indicates that that it is possible to catch more women with mental health needs, not just those that have recently given birth.
The platform was overwhelmingly accepted by the clinicians and had glowing remarks from those participating. Here are some of the comments:
“I personally feel I now have a support team to assist with these patients”
“It is easier for someone having those kind of thoughts to simply press a choice on your screen [rather] than actually plastering it on a paper for everyone to see”
“They would be called immediately and care is started quickly”
“Mammha has been absolutely wonderful, the patients are contacted almost immediately with follow up. Excellent communication”
“It’s an amazing resource that helps patients with postpartum depression find the resources needed to get through this difficult time in a safe and effective manner.”
“I wish I would have been using this sooner. Easy to use for patients and myself.”
The data from this research study was recently presented at the American Telemedicine Association conference in San Antonio as well as the Florida Maternal Mental Health Collaborative annual conference and Mammha’s Maureen Fura expressed sincere gratitude for the HITLAB team for generating the much needed data to help her company progress to the next development steps. “Receiving the BTA Challenge award and the research project was just a much-needed shot in the arm, validating that we are on the right track and also giving us ammunition to continue to make progress as a company. It was a joy working with Kat and the data was just so helpful.”
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