One in 7 women suffer from it, and yet, fewer than 20 percent get treated — that is the reality of postpartum depression (or PPD) in America. OB-GYNs, often the first medical professionals in a position to recognize PPD in new or expecting mothers, are rarely trained to make that diagnosis, let alone provide mental health care. Nancy Byatt, a psychiatrist at the University of Massachusetts Medical School, wants to change that.
“Every time a woman is seen by an obstetrics provider it is an opportunity to detect depression, educate them about it and to really engage them in treatment,” Byatt told NPR.
In order to help, Byatt helped launch a program called the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms), which offers workshops and a toolkit to help doctors, midwives and nurse practitioners recognise depression symptoms in pregnant and new moms throughout the state.
With the program, providers can also call MCPAP for consultations regarding psychiatric care, community resources and referrals, or both. MCPAP provides real-time psychiatric consultation over the phone, which is available for both moms and providers, and helps to assist the doctors in addressing their patients’ mental health and/or substance use concerns.
Byatt created the program after doctors repeatedly came up to her and told her that they didn’t know how to help pregnant and new moms heal from depression. They wanted a “lifeline” to support them.
“They said ‘We want to address this. We think it’s so important. We don’t know what to do. We haven’t been trained, we don’t have the resources,'” Byatt recalls. “We essentially hold their hand and help them figure out how to help the patient.”
Moms with perinatal depression (which can strike during pregnancy or after childbirth) can encounter feelings of extreme sadness, anxiety, and fatigue that can make it difficult for them to complete day-to-day chores for themselves or others. Untreated depression can negatively impact the entire family, lead to health complications for babies, and can raise health care costs by millions of dollars. Still, stigma surrounding the issue has historically slowed progress toward a solution.
“It’s very hard to admit that something’s not right … when you have a new baby in the house,” Jennifer Ford, who suffered from postpartum depression, told NPR. “It’s supposed to be this wonderful happy time, and that’s not how it was.”
The support provided by MCPAP for Moms has increased physicians’ confidence when it comes to screening for and treating mental health issues, however, and that confidence has begun to change the attitudes of patients as well. “Patients don’t feel embarrassed anymore … to talk about it,” OB-GYN Dr. Christopher Conlan told NPR. “They are very comfortable starting medication and they’re very comfortable seeing a counselor.”
Aside from taking the shame out of it, MCPAP also strives to provide long term help for patients by referring mothers to outpatient mental health and/or substance use support as needed.
“There is a great deal happening to address maternal mental health,” Byatt told Care For Your Mind. “We need to continue to build capacity and raise practice standards, along with providing systems that support OB providers through education and consultation.”
One such program helping families cope with the challenges of maternal mental health is the New Family Home Visits initiative just announced in New York City. Soon, all first-time families in the city will be able to get up to six home visits from health professionals to help with issues like PPD, regardless of gender or sexual orientation or income. Similar programs exist in cities like Chicago and Durham, but this will become the largest yet as it expands from Brooklyn to the rest of NYC through 2024.
MCPAP for Moms has grown to cover 80 percent of the deliveries in Massachusetts. The 21st Century Cures Act, signed into law by President Obama in 2016, funds various grants to help diagnose and treat various health issues, including PPD. Through this legislation, seven other states have been funded to implement similar programs — hopefully with many more to come.