The Task Force to Study Maternal Mental Health has submitted its recommendations for improving prevention and care for perinatal mood and anxiety disorders (PMADs) in Maryland to Governor Larry Hogan and the Maryland General Assembly. The Assembly passed legislation in 2015 to establish the Task Force, assigning the group with identifying vulnerable populations and risk factors for PMADs and making recommendations on legislation, policy initiatives and budgetary priorities to address and improve unmet maternal mental health needs in Maryland. Read the full report here.
One in seven women experience depression during pregnancy or in the first 12 months after delivery, and more than 400,000 infants every year are born to mothers with depression, making perinatal depression the most underdiagnosed and untreated obstetric complication in the United States. Perinatal mood and anxiety disorders (PMADs) are treatable once recognized, yet 50 percent of all mothers who experience these disorders are never identified.
Through a total of 15 recommendations, the Task Force urged the state to:
- Improve early identification and treatment of PMADs through increased screening, treatment resources and expanded provider education,
- Enhance peer support programs for mothers, coupled with public education initiatives aimed at increasing awareness about PMADs, and
- Expanded maternal mental health services for pregnant women and new moms.
Improve early identification, treatment resources and provider education
Screening and identification of PMADs greatly improve the likelihood of a quick recovery for mothers, supports healthy child development and offers long-term health care cost savings. Women typically visit their obstetrician and gynecologist during pregnancy and visit a pediatrician for infant check-ups more often than other health professionals, so these providers are in an ideal position to screen for PMADs. The Task Force recommends requiring mental health screenings for women during pregnancy and throughout the first year postpartum suggests offering maternal mental health information and resources for care to mothers and families.
In addition to screening, the Task Force recommends developing free maternal mental health CME/CEU training for providers to ensure improved clinical outcomes for mothers and continued support beyond the initial screening. The Task Force also advises expanding the psychiatric consultation programs provided through the Maryland Behavioral Health Integration in Pediatric Primary Care (BHIPP) to assist providers in addressing the emotional and mental health needs of their pregnant and postpartum patients.
Develop peer support and public education programs for mothers
Peer support programs allow individuals who lived with mental health disorders to use their experiences to help others guide their own recoveries, and have been proven to reduce symptoms and hospitalization, increase social support and improve well-being. The Task Force recommends that Maryland expands resources for peer support programs to enable more specialized and comprehensive support for new and expectant mothers. The Task Force report uses the Massachusetts program MotherWoman as an example of a comprehensive peer support program for pregnant women and new moms. To supplement peer support programs and to reduce the stigma associated with PMADs, the Task Force proposes creating centralized, multicultural public education materials and resources for patients and families to more easily find information. The MHAMD Healthy New Moms campaign is an existing public education campaign that provides materials and information to pregnant women and new moms.
Expand maternal mental health services for pregnant women and new moms
The Task Force recommends establishing specialized maternal mental health programs to best meet the needs of mothers experiencing PMADs and proposes coordination of treatment for substance use disorders (SUDs) and maternal mental health. Methods for coordinating treatment include screening for SUDs throughout the pregnancy, improving post-partum follow-up and ensuring SUD treatment providers incorporate both prenatal care and mental health care into their treatment plans.
The Task Force recommendations facilitate a path toward more comprehensive support and treatment for women who are experiencing PMADs, reduce stigma associated with maternal mental health conditions and a greater level of oversight for Maryland to continue improving its maternal mental health services.