Date of Conferral

2-6-2025

Degree

Doctor of Human Services (D.H.S.)

School

Human Services

Advisor

Virginia Smith

Abstract

Many women will experience a mood disorder at some point during the perinatal period, which begins at conception and extends to at least the 1st birthday of their child. With the expansion of Medicaid in the U.S. state of North Carolina in 2023, many new women of childbearing age have coverage that includes mental health services. However, despite this huge surge in newly insured women there is no notable increase in the number of mental health providers (social workers, clinical mental health counselors, etc.) in the state who accept Medicaid. The purpose of this study was to determine what service providers say is preventing mental health clinicians from signing on to accept Medicaid clients. Lewin’s theory of change and force field analysis provided the conceptual framework of the study and was used to determine participating clinicians’ perceptions of barriers and supports for perinatal mental health clinicians in North Carolina. Two anonymous surveys were posted on a Facebook group for perinatal mental health clinicians in North Carolina. The first contained open-ended questions designed to gather information from the participants about their perceptions. The second asked participants to rank order the key responses that were identified in the first survey. Thematic analysis of responses from nine participants identified reimbursement rates and concerns about billing and authorization processes to be the most concerns of participating clinicians. This study may affect positive social change by informing policy makers of the need to streamline Medicaid administrative processes to encourage higher levels of involvement among already trained perinatal providers.

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