Mind the Gap Collective Impact Initiative Aims to Make Mental Health Disorders During Pregnancy a National Priority

It’s hard being pregnant. Your body is changing, your hormones are shifting, and you’re preparing to bring a new life into the world. It’s a lot. In addition, pregnancy can also cause perinatal mental health disorders, which occur during pregnancy, and not after, like postpartum depression, which is more widely known. In fact, women who experience perinatal depression are at a higher risk for developing postpartum depression, so understanding the signs are important. Since there are all these disorders spanning pregnancy and postpartum, they are collectively called Perinatal Mood and Anxiety Disorders or PMADs.

“If you are a woman suffering from perinatal depression, anxiety or mood disorders, you are not to blame, you are not alone, and help is available,” said Dr. Wendy Davis, Executive Director of Postpartum Support International (PSI).

Data show that perinatal depression affects one out of seven pregnant and postpartum women, according to a study in Obstetrics & Gynecology. Between 15 and 20 percent of women giving birth annually (estimated at 4 million in the United States) will experience a mental health disorder at some point during pregnancy or postpartum. About 30 percent of women with depression during pregnancy will continue to have depression 12 months after delivery if not treated, found a study in Lancet.

Perinatal mental health does more than just affect mom. It significantly impacts immediate family, too. It’s relatively unknown but true that up to 25 percent of new dads—found a study in Psychiatry (Edgmont)—can have perinatal depression; having a partner with perinatal depression is a risk factor. Furthermore, a woman suffering from a perinatal mental health disorder can have trouble bonding with her baby, doubt her ability to care for the newborn and may even think of harming herself. These issues pose a substantial risk to moms and their babies, potentially negatively impacting learning, behavior and overall functioning of infants and children.

Despite the prevalence of perinatal mental health disorders, research funding as measured by National Institutes of Health and Centers for Disease Control and Prevention grants ranks far below funding for other conditions that impact women.

Check out these numbers: Heart disease impacts 1 out of 5 women and receive $3.3 billion in federal funding. Breast cancer affects 1 out of 8 women and gets $1.4 billion in federal funding. One out of 200 women have lupus; it gets $197 million from the government. But perinatal mental health disorders, which impacts 1 out of 7 women, only receives $54 million in federal funding.

Screening for mental health disorders during pregnancy and postpartum have yet to be universally adopted or available. And if a woman does get screened showing a positive screen for depression, or other mental health disorders, referral and access to treatment aren’t always available. According to studies in Obstetrics & Gynecology and Journal of Womens Health, less than 30 percent women who screened positive for depression and anxiety get treatment.

Over the past decade, a number of national, state and local organizations have made tremendous strides in addressing challenges related to screening, diagnosis and treatment of perinatal mental health.

Recently, key professional associations like the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, Postpartum Support International (PSI) and the U.S. Preventive Services Task Force have issued guidelines to ensure that screening for mental health disorders is universal, routine and standard with appropriate follow-up to diagnosis and treatment. But coordinated national efforts are needed to ensure that these guidelines are implemented and that barriers are eliminated to access and coverage of perinatal mental treatment for mothers. National public awareness is needed to help lower the stigma, provide education, and encourage help seeking.

Mind the Gap Collective Impact Initiative

That’s where the Mind the Gap initiative comes in. Building on a landscape analysis conducted by researchers at The Reilly Group, the Initiative aims to ensure perinatal mental health is a national priority and to improve outcomes for moms, dads, babies, families and ultimately the community.

“Maternal mental health needs to be part of a broad community and national conversation that includes women’s health, public health, mental health, and other public and private sector organizations working together. The Mind the Gap Initiative is focused on collective action with important organizations like Healthywomen.org to help moms and families,” said Dr. Davis, Executive Director of PSI.

Based on the landscape analysis of the issues and expert input from leading organizations, Mind the Gap developed consensus on a set of recommendations with specific actions to ensure that perinatal health is a national priority. “Mom’s mental health needs impact the whole family unit, and we can do so much when we work together in common purpose,” says Colleen Reilly, President and CEO of The Reilly Group who is co-leading the Initiative with PSI and national organizations.

HealthyWomen.org is one of many national organizations providing medical, educational and policy guidance. “This is an important national issue that a lot of people don’t know about and we look forward to educating women and their health care providers,” says Beth Battaglino, RN, CEO of HealthyWomen.

Even though there are great models and programs, an overall gap remains for the appropriate detection, treatment and access to care for women with perinatal mental health disorders in the United States. Mind the Gap seeks to bridge that gap by forming a diverse coalition of leaders and stakeholders, including federal agencies, researchers, provider associations and patient advocacy groups.

“A lot of work needs to be done,” says Battaglino. “Historically, the focus has been on the baby—not on mom’s health. The OB/GYN and pediatrician, and others involved in maternity and infant care need to be in a position to know how to screen and refer mom to get the help she needs.”

“At PSI, we understand women may feel alone and scared. But they’re not alone and they’re not to blame. Help is available. We should never blame a mother,” says Dr. Davis. “It’s a medical condition, just like other medical conditions a woman may experience during pregnancy or postpartum. The good news is that effective treatments are available that work, support services that help, and evidence-based interventions that we can provide to address mental health and well-being. We have to get the word out there. By working together, we can going to close the gap in care for moms and families.”

For more information on Mind the Gap, contact colleen@reillygroupinc.com or wdavis@postpartum.net.

For more information on perinatal mental health, visit Postpartum Support International.

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It’s hard being pregnant. Your body is changing, your hormones are shifting, and you’re preparing to bring a new life into the world. Pregnancy can also cause perinatal mental health disorders, which occur during pregnancy, like postpartum.
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