MOCHA: Embedded Inpatient Mental Health Care for High-Risk Perinatal Patients

Conditions studied

Anxiety Disorders, Stress Disorders, Post-Traumatic, Pregnancy, High Risk, Depressive Disorder, Major, Pregnancy Complications, ADHD - Attention Deficit Disorder With Hyperactivity

About this study

Pregnant and postpartum patients hospitalized for medical complications experience high rates of depression, anxiety, and trauma-related symptoms, yet access to timely psychiatric care during obstetric hospitalization is limited. Project MOCHA integrates early mental health screening, trauma-informed psychotherapy, and structured follow-up into routine inpatient maternity care for individuals at elevated clinical risk. This single-arm implementation study examines the feasibility, acceptability, and fidelity of delivering a Collaborative Mental Health Care Program within a high-risk obstetric inpatient setting. The program includes brief inpatient psychotherapy, symptom monitoring, and post-discharge follow-up over three months. Preliminary changes in depression, anxiety, attention-deficit hyperactivity disorder, and posttraumatic stress symptoms will be assessed to inform future effectiveness trials and broader health system integration.

Interventions

• Behavioral: Collaborative Mental Health Care Program (CMHCP) — The CMHCP intervention provides mental health support to pregnant and postpartum patients hospitalized for medical complications on a high-risk obstetric unit. After enrollment, participants complete a brief mental health questionnaire. During their hospital stay, participants may receive brief individual therapy sessions delivered in person and adapted to medical needs and length of stay. Therapy uses trauma-informed strategies to support emotional well-being. Participants complete short symptom check-ins during hospitalization, and some may receive optional telehealth sessions if additional support is needed. Participants are contacted about three months after discharge for follow-up to assess mental health symptoms and well-being.

Primary outcomes

• Change in depressive symptoms measured by the Edinburgh Postnatal Depression Scale (EPDS) (From baseline (hospital admission) to 3 months post-discharge)
• Change in anxiety symptoms measured by the Generalized Anxiety Disorder 7 (GAD-7) (From baseline (hospital admission) to 3 months post-discharge)
• Change in posttraumatic stress symptoms measured by the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) (From baseline (hospital admission) to 3 months post-discharge)
• Feasibility of weekly symptom screening during hospitalization (During hospitalization (from admission to discharge))
• Acceptability of psychotherapy sessions measured by the Session Rating Scale (SRS) (During hospitalization (from admission to discharge))
• Fidelity to psychotherapy protocol: percentage of scheduled sessions delivered (During hospitalization (from admission to discharge))
• Acceptability of the MOCHA program measured by the Client Satisfaction Questionnaire (CSQ-8) (3 months post-discharge)
• Change in symptoms of Attention Deficit Hyperactivity Disorder as measured by Adult ADHD Self-Report Scale (From baseline (hospital admission) to 3 months post-discharge)

Eligibility information

Study locations

• Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana 46202 United States