Perinatal Mental Health
Perinatal Mental Health services provided by Dar a Luz certified nurse midwives for established clients
- Utilize validated tools (ex. PHQ9, EPDS) to screen and assess for perinatal mental health disorders.
- Identify bio-psycho-social contributors to psychiatric illness in women.
- Utilize evidence-based treatment strategies for selecting and implementing medical and non-medical treatments for common depressive and anxious disorders.
- Treat hormonal mood conditions related to Premenstrual Syndrome, Premenstrual Dysphoric Disorder, infertility treatment, pregnancy, birth, the postpartum transition and breastfeeding, and menopause.
- Prescribe medication management (mono-therapy only) for preconception, pregnant, and postpartum women.
- 24/7 access to Certified Nurse Midwife for crisis management.
- Care coordination: referring clients to primary care, specialty healthcare and social services to support health, wellness and independence.
Ketamine Infusion Therapy (KIT)
Ketamine was discovered in 1962 by Parke-Davis in an attempt to develop a safe anesthetic that could be given by an untrained person in certain situations such as the battlefield; it was used first during the Vietnam War. It was FDA approved in 1970. It then moved into the operating room and is often used on children because of its safety. It has also been adopted by veterinarians for animal anesthesia. It is currently a Schedule III controlled substance.
Ketamine also has anti-depressant effects. This was realized in the 1970s but formal studies weren’t initiated until the 1990s. The first paper was published in 2000 and the results have been replicated many times over for people particularly with treatment resistant depression (TRD). There are also indications for people with anxiety, post-traumatic stress disorder (PTSD), bipolar depression, and other conditions in the absence of other contraindications (identified below). When ketamine is used for these psychiatric purposes, it is used at sub-anesthetic doses which are significantly lower than doses used for anesthesia purposes.
About ⅓ of patients treated with traditional anti-depressants such as SSRIs and SNRIs do not respond, despite multiple different agents. Ketamine has become well regarded for safe and rapid relief of depressive symptoms. “Ketamine is the only legal potentially psychedelic medicine in use” and while its use for TRD is considered off-label, there is extensive research that supports it. Ketamine’s tolerability and safety have been demonstrated over almost five decades.
There are several routes of administration that ketamine can be given therapeutically. Only ketamine that is administered intravenously has 100% bioavailability because it enters the circulation and does not have to be absorbed through muscle or other mucosa. This makes the process of ketamine infusions incredibly consistent and predictable. In addition, ketamine is short-acting with a half-life of 2.5 hours; if there is any reason to stop the infusion, the effects of the ketamine wear off in a matter of minutes.
KIT is not for use during pregnancy. Special considerations are made for breastfeeding people.
KIT will be offered and monitored by licensed providers with ketamine assisted psychotherapy (KAP) training.
Refer out for
Therapy (individual, couples, CBT, DBT, EMDR, etc), group therapy, domestic violence resources, disordered eating treatment
Complex Psychiatric Medication Management
Substance Use Disorder
Short/Long-term hospitalization
Crisis/Emergency services
Case Management
Consultative Services