In their Words: Healthcare Providers Share the Impact of Perinatal Psychiatry Access Programs
The vast majority — as many as 75% — of women experiencing a maternal mental health condition do not get the treatment they need. One reason is because there are fewer than 500 psychiatrists trained in maternal mental health to care for the 800,000 women (source 1, source 2) who experience maternal mental health complications each year. To address this issue, Perinatal Psychiatry Access Programs (commonly referred to as “Access Programs”) were established in 2018.
Access Programs are state-based programs that help address the demand for maternal mental health care by educating frontline providers — such as obstetricians, family physicians, pediatricians, and psychiatrists — about how to treat maternal mental health conditions. This coordination between maternal mental health psychiatry specialists and frontline healthcare providers leverages scarce psychiatric resources and increases access to timely and evidence-based care.
Access Programs provide:
Education to frontline providers to help them screen and treat women experiencing maternal mental health conditions.
Technical assistance to help providers and practices implement screening and treatment protocols.
Consultation with psychiatrists for more complex cases.
Resources and Referrals for local supports such as therapists and support groups.
The Impact of Access Programs in the Words of Healthcare Providers
MMHLA asked healthcare providers to share how Access Programs have helped them in their work. Below is some of the feedback we received demonstrating the positive impact that Access Programs are having on maternal mental health care.
“I had a new patient scheduled with me later that day, and I knew she was newly pregnant, taking multiple psychiatric medications, and she was a high-risk pregnancy. I was able to talk with Dr. Emerick from the line and get great general information and strategies on how to approach my patient and also very specific, up-to-date and evidence-based information about medications and their use and risk. When I saw my patient, I felt informed, and I could help her make really safe choices for her and her pregnancy. It helped me significantly.”
— Vince Placido, Psychiatrist, Arizona
“[The Access Program] Helped me assess the risks of working with a patient who was drinking heavily and wanted to discontinue abruptly.”
— Sarah Wesch, Psychologist, Kansas
“[The Access Program] Provided wonderful presentations about various types of needs to help me provide effective treatment to my perinatal clients.”
— Lisa Potter, Therapist, Kansas
“[The Access Program] Helped us develop policies and procedures for screening program participants in our group prenatal education program and in our one-on-one home visiting programs.”
— Cari Schmidt, Research Professor, Kansas
“I needed assistance in managing a patient on stimulants for ADHD who was having hallucinations. The line was incredibly easy to use with great service from the social worker and psychiatrist.”
— Melissa Holland, Pediatrician, Louisiana
“I am the director [of the Michigan Access Program], and I work with frontline primary care providers who serve women in pregnancy and postpartum with mental health concerns. I can attest first hand how important it is for the primary care docs and other professionals (doulas, lactation consultants, etc.) to have this ‘lifeline’ to call and ask questions about what resources are available, clarify diagnostic questions, screening results, and discuss treatment options, including safe medications. This is a life-changer because treatment can start immediately and women do not fall through the cracks. We also develop same-day therapy support, and the women utilizing this service are thankful and appreciate the quick and unbureaucratic approach to care and help.”
— Maria Muzik, Director of Perinatal Access Program, Michigan
“I use [the North Carolina Access Program] regularly to help access mental health services for both children, who I serve as a pediatrician, and their postpartum mothers. The program has been crucial in getting children and mothers the care they need and incredibly helpful for the entire family.”
— Brittany Raffa, Assistant Professor of Pediatrics, North Carolina
“I use this service often for consultations regarding medication safety and management in perinatal mental health patients. Often these patients need immediate care and can’t wait for the lengthy process of initiation to perinatal psychiatry.”
— Emily Zolten, CMN, Vermont
“[The Access Program] was helpful in staffing cases and getting treatment recommendations for the perinatal population. This is a knowledge gap for me, and perinatal care is available in my community; however, perinatal psychiatry is not. I really value the support from the [Washington Access Program] and so have my patients.”
— Anonymous healthcare provider, Washington
A Look at Access Programs Today
When federal funding first became available for Access Programs in 2017, 30 states and territories applied but only seven states received grants due to limited funding. Today, there are over 30 state Access Programs, with 13 funded by the federal government.
Additionally, there are two national programs: 1) the Veterans Administration runs a reproductive psychiatry access program specifically for the Veteran community, and 2) Postpartum Support International provides a Perinatal Psychiatric Consult Program.
A map of the Perinatal Psychiatry Access Programs in the U.S. There are over 30 state Access Programs, with 13 funded by the federal government. Federally funded Access Programs include: Colorado, Kansas, Kentucky, Louisiana, Missouri, Mississippi, Montana, North Carolina, Tennessee, Texas, Vermont, and West Virginia. There is also a regional program in Los Angeles County, California.
Support for the Access Programs is provided by the National Network of Perinatal Psychiatry Access Programs, which convenes leaders of the Access Programs to:
Facilitate peer learning and resource sharing among aspiring, emerging, and established Access Programs and relevant partners across the U.S.
Nurture relationships to promote support, innovation, and expansion of existing and future programs.
Implement quality improvement, program evaluation, and equity advancement within and across programs.
These programs have proven to be cost-effective and efficient ways to expand maternal mental health care in our current healthcare infrastructure and workforce, and they have become a proven model that prevents mothers from falling through the cracks.
Maternal Mental Health Leadership Alliance (MMHLA) has played a key role in advocating for over $58 million in federal funding to support these programs. Our goal is to have an Access Program supporting every U.S. state and territory.
To support our advocacy work, you can make a donation and sign up to our newsletter below to be informed of opportunities that support maternal mental health programs.
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