Professor Ora Nakash and her colleague at Rutgers University, Christina Kang-Yi, were recently awarded a grant through the Learning Health System Scientist Training and Research Program at Rutgers. Their project, “DECIDE to Improve Maternal Mental Health Care Delivery,” will adapt an evidence-based shared decision-making model to develop provider training to improve maternal mental health care delivery for ethnically and racially diverse populations.
Nakash was part of the team that developed the DECIDE decision-making model, which stands for: Decide the problem; Explore the questions; Closed or open-ended question; Identify the who, why, or how of the problem; Direct questions to your health care professional; Enjoy a shared solution.
This new project extends the original DECIDE by adding perinatal mental health care topics and creating training modules to reduce the burden on mental health care providers. As part of their research, Nakash and Kang-Yi will assess the appropriateness of this model in maternal mental health care delivery.
The project expands Nakash’s existing research developing and implementing provider interventions to improve quality of care for marginalized populations.
“I was part of the team that developed the original DECIDE intervention, and it is my hope that with this funding we can continue to build on this work and improve quality and equity of mental health care in perinatal care.”
Working collaboratively on all aspects of this research, Nakash will lead the development of the intervention itself and Kang-Yi will lead the recruitment process of finding 35 providers and implementing the pilot study. The providers will include psychologists, counselors, social workers and midwives who provide mental health care to pregnant and postpartum people within various health systems.
This project underscores the importance of one of the essential competencies in social work: shared decision-making skills, which Nakash says is important for delivering all mental health care, but needs to be tailored because of the unique mental health needs of pregnant and postpartum parents.
“DECIDE is expected to be an effective guiding tool for mental health providers in making shared decisions with pregnant and postpartum patients with psychiatric disorders,” she says.
Developed to improve equity in shared decision-making in behavioral health in marginalized adults with mental illness, DECIDE helps mental health care providers improve their skills by training them on perspective-taking (the act of looking at a situation from another point of view), reducing attributional errors (overemphasizing internal client personality traits and ignoring external or systemic factors) and helping clients feel safer in receiving support. Nakash and Kang-Yi hope to expand this model of culturally-competent care to the perinatal context.
Nakash says, “I am excited to continue to build on previous work and together with my colleague and the community advisory board, adapt and implement provider intervention that will improve patient engagement in care.”
