Advocacy

Maternal Mental Health Leadership Alliance and the March of Dimes are pleased to co-host Maternal Mental Health Advocacy Day on March 4, 2021.  Advocates from across the country will meet virtually with key Members of Congress to ask for additional funding for established MMH programs, including:

  • $5 million for additional grants to states to create programs to address MMH
  • $2 million for a national Maternal Mental Health Hotline to provide 24/7 specialized voice and text support

Here are important documents for Advocacy Day:

  • One-page Fact Sheet / Infographic LINK
  • Advocacy Toolkit LINK
  • Social Media Toolkit LINK
  • Organizational Sign-on Letter LINK
  • Become a Co-Signor on the Organizational Sign-on Letter LINK

MMHLA’s MMHLA Advocacy Toolkit 

This Toolkit is designed to help perinatal mental health (PMH) advocates understand the
importance of their voices in raising awareness and influencing public policy to better support
the mental health of women and other birthing people during the perinatal timeframe (during
pregnancy and year following pregnancy).

Recognizing that advocacy and lobbying may sound scary or feel overwhelming, this Toolkit
provides information and tools to empower advocates to tell their stories effectively, to build an
advocacy network, and to put advocacy into action. Worksheets are provided so advocates can
build their own Toolkits with items such as talking points, scripts for telephone calls, sample
emails and letters, and more.

Individuals and organizations for whom this Toolkit is designed include:

  • Individuals with lived PMH experience.
  • Family and friends impacted by PMH.
  • Medical providers and affiliated medical
    professionals who interact with perinatal people.
  • Mental health providers who treat people experiencing PMH conditions.
  • Nonprofit organizations providing services supporting perinatal people.

Toolkit is also available at bit.ly/pmhtoolkit

BIPOC Resources

Resources and Organizations Focused on the maternal health and mental health of Black, Indigenous, and People of Color

This list is not meant to be all-inclusive but rather serves as a starting point for finding resources and information.

Akoma Counseling Concepts:  A DC-based female minority owned mental health counseling and consultation practice that specializes in women’s mental health and perinatal mental health counseling.

Ancient Song Doula Services:  Tackling issues affecting communities of color through community, advocacy, reproductive/birth justice, and education.

Birth Center Equity Fund:  The Birth Center Equity Fund focuses on making birth center care an option for every person who wants it, by growing and sustaining birth centers led by Black, Indigenous, and other people of color. 100% of funds raised go to BIPOC birth centers.

Black Mamas Matter Alliance:  An advocacy organization focused on improving the health and well-being of black women through research, policy, and cultural shifts.

Black Mental Wellness:  A corporation of clinical psychologists who recognize the need for culturally competent professionals to collaborate and address mental health issues that are prevalent and unique to the experiences of Black people.

Black Women’s Health Imperative:  The first nonprofit organization created by Black women to help protect and advance the health and wellness of Black women and girls.

The Bloom Collective:  A Baltimore-based center for birth education, lactation, and perinatal support.

Common Sense Childbirth:  Founded by midwife Jennie Josphe, the mission of this organization is to inspire change in maternal child health care systems worldwide and to re-empower the birthing mother, father, family and community by supporting the providers, practitioners and agencies that are charged with their care.

Diversity Uplifts:  A consulting and training nonprofit organization determined to improve the wellbeing of individuals and communities by supporting diverse populations and increasing cultural competence and humility among providers who serve them.

The Loveland Foundation:  This fund provides grants to Black women and girls to obtain high-quality mental health care.

Mamatoto Village:  A not-for-profit organization committed to furthering the careers of Women of Color and providing perinatal support services to all, including home visiting, doula, childbirth education, and lactation support.

Midwives for Black Lives:  This BIPOC midwife collaborative movement was created to improve birth outcomes for Black families through scholarships for Black student midwives.

MomCongress Black Learn, Listen, and Lift Toolkit:  This toolkit includes listings of books, films, podcasts, organizations and more designed to help non-Black individuals understand how deeply racism runs in our country and to ensure Black women and Black America are heard, treated equally, and are respected for all that has been endured.

National Association to Advance Black Birth:  Working to promote midwives, doulas, and training programs to improve the care of Black women, persons, and infants.

National Black Midwives Alliance:  A member-supported organization focused on raising awareness about black midwives and eliminating disparities in U.S. perinatal health.

National Birth Equity Collaborative:  Focused on creating solutions that optimize Black maternal and infant health through training, policy advocacy, research, and community-centered collaboration.

Perinatal Mental Health Alliance for People of Color:  A program within Postpartum Support International geared towards building capacity in the perinatal mental health field to better support families and providers of color around perinatal mood and anxiety disorders.

Shades of Blue Project:  A Texas-based nonprofit whose mission is to break cultural barriers in maternal mental health.

Shades of You, Shades of Me:  The only conference in the United States focused exclusively on multicultural maternal mental health.

SisterSong:  A reproductive justice organization focused on improving the lives of women of color through community organizing and advocacy to catalyze systemic change.

Therapy for Black Girls:  Dedicated to decreasing stigma and increasing access to culturally competent mental health care for black people.

Books, Movies, Podcasts, Radio, TedTalks, Videos

Scores of books about maternal mental health issues are available; most have been written since 2000.

Movies

  • Dark Side of the Full Moon is a full-length documentary exploring what happens when motherhood collides with mental health.
  • Not Carol is a feature length documentary examining a harrowing case of postpartum psychosis.
  • When The Bought Breaks — produced by postpartum depression survivor Brooke Shields — explores postpartum depression.

Plays

  • Playing Monopoly With God shines a much needed spotlight on the often unspoken traumas of the postpartum experience.
  • This Is My Brave hosts story-telling events across the country to to bring stories of mental illness and addiction out of the shadows and into the spotlight.

Several podcasts either focus on maternal mental health or feature specific episodes about maternal mental health.

  • Adventures with Postpartum Depression.  Courtney Novak, a postpartum depression survivor, hosts this podcast with the goal of ending the stigma about postpartum depression through story-telling.
  • Economic Hardship Reporting Project.  Reproductive psychiatrist Dr. Sinmi Bamgbose shares how she’s working to expand mental health resources for Black birthing parents.
  • Get Healthy 360.  In this episode, perinatal psychiatrist Dr. Marley Doyle talks about postpartum depression and other maternal mental health challenges.
  • LifeKit.  National Public Radio’s podcast features tools to help get through life.  This episode is entitled What is Postpartum Depression? Recognizing The Signs and Getting Help.
  • Mom and Mind.   Perinatal mental health specialist Katayune Kaeni, Psy.D. shares real life stories of moms, dads and family, along with interviews with experts, leaders and advocates in the field of maternal mental health and maternal health.
  • PsychCentral.  In this episode of Psych Center, licensed clinical psychologist Emma Basch shares facts and statistics about maternal mental health.
  • PostpartumMen.  Dr. Will Courtney talks about how men can overcome postpartum depression.

National Public Radio has aired over 100 stories about postpartum depression and related maternal mental health issues in the last decade.  Here are the highlights from the last two years:

Postpartum Support International is the world’s leading organization in supporting women experiencing maternal mental health issues and education the providers who care for them.

The following organizations have videos and public service announcements:

YouTube has scores of videos about POSTPARTUM DEPRESSION and related maternal mental health issues.

Conferences

National Association of Perinatal Social Workers
April 29-30, 2021 / Virtual
Learn more HERE

Shades of You, Shades of Me
Multicultural Maternal Mental Health Summit / Devotion Starts Within
May 6-7, 2021

Postpartum Support International
July 7-11, 2021 /  Virtual
Learn more HERE

Marce of North America
October 21-24, 2021/ Virtual
Call for abstracts is open.  Deadline is April 15.
Learn more HERE.

North American Society for Psycho-Social Obstetrics and Gynecology
Monthly webinar series through August 2021
Learn more HERE.

International Marce Society
SAVE THE DATE: September 19-21, 2022 / London, England / In-Person
Learn more HERE.

Black Maternal Health Conference
April 16-17, 2021 / Virtual
Learn more HERE

American College of Obstetrics and Gynecology
April 30 – May 2, 2021 / Virtual
Learn more HERE

American College of Nurse-Midwives
May 23-25, 2021 / Virtual
Learn more HERE

Association of Maternal & Child Health Programs
May 22 – 25, 2021 / Virtual
Learn more HERE

American Academy of Family Physicians
September 28 – October 2, 2021 / Virtual
Learn more HERE

Childbirth and Postpartum Professional Association
September 24 — October 3, 2021 / Virtual
Learn more HERE

American Academy of Pediatrics
October 8-12, 2021 / Philadelphia PA / In-Person and Virtual
Learn more HERE

Association of Women’s Health, Obstetric, and Neonatal Nurses
October 9-13, 2021 / Orlando FL / In-Person
Learn more HERE

American Public Health Association
October 23-27, 2021 / Denver CO / In-Person and Virtual
ABSTRACTS AND PROPOSALS DUE MARCH 21, 2021
Learn more HERE

Zero To Three
October 25-29, 2021 / Virtual
Learn more HERE

DONA International
October 27-30, 2021 / Calgary CA / In Person
Learn more HERE

Anxiety and Depression Association of America
March 18-19, 2021 / Virtual
Learn more HERE

American Psychiatric Association
May 2021 / Virtual
Learn more HERE

National Alliance on Mental Illness
July 27-28, 2021 / Virtual
Learn more HERE

American Psychological Association
August 12-15, 2021 / Virtual
Learn more HERE

Performance Measures

In 2019, the National Committee for Quality Assurance — with assistance from the ZOMA Foundation and the California Healthcare Foundation — developed care quality measures around screening for depression during pregnancy and the postpartum period.  In 2020, these measures were added to the national Healthcare Effectiveness Data and Information Set (HEDIS), which includes measures for physicians, insurance providers, and other organizations.  The two measures are:

  • PRENATAL Depression Screening and Follow-Up.  The percentage of deliveries in which members were screened for clinical depression while pregnant and, if screened positive, received follow-up care.  Two rates are reported:
    • Depression Screening: The percentage of deliveries in which members were screened for clinical depression during pregnancy using a standardized instrument.
    • Follow-Up on Positive Screen: The percentage of deliveries in which members received follow-up care within 30 days of screening positive for depression.
  • POSTPARTUM Depression Screening and Follow-Up.  The percentage of deliveries in which members were screened for clinical depression during the postpartum period and, if screened positive, received follow-up care.  Two rates are reported:
    • Depression Screening: The percentage of deliveries in which members were screened for clinical depression during the postpartum period using a standardized instrument.
    • Follow-Up on Positive Screen: The percentage of deliveries in which members received follow-up care within 30 days of screening positive for depression.

Learn more here: NCQA Perinatal Depression Measures.

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Download MMHLA’s newsletter about Performance Measures.

In July 2020, a WorkGroup provided an annual review and made recommendations to the Medicaid Core Set of performance measures.  The WorkGroup recommended adding the POSTPARTUM Depression Screening and Follow-Up Measure but recommended against adding the PRENATAL Depression Screening and Follow-Up Measure.  A public comment period was available until August 10.

Learn more here: Recommendations for Improving the Core Sets of Health Care Quality Measures for Medicaid and CHIP.  Information about prenatal and postpartum depression screening can be found on pp. 16-18.

____________________________

MMHLA believes strongly that women should be screened for depression (and related maternal mental health conditions) both during pregnancy and in the postpartum period.  MMHLA took the following actions to encourage the WorkGroup to recommend adding the PRENATAL Depression Screening and Follow-Up Measure:

  • Submitted COMMENTS to the WorkGroup.
  • Signed onto a LETTER originated by 2020Mom.
  • Mobilized other organizations to provide feedback to the WorkGroup.

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Download MMHLA’s newsletter about Performance Measures.

Policy — Federal

LEGISLATION.

The following pieces of legislation were included in the National Defense Authorization Act to address maternal mental health:

  1. Military Mothers Mental Health Assessment Act.  The Comptroller General of the United States shall conduct a study on prenatal and postpartum mental health conditions among members of the Armed Forces and the dependents of such members. Read the entire text of this legislation HERE.
  2. TRICARE Coverage for Doulas Support Act.  The Secretary of Defense shall commence carrying out a 5-year demonstration project designed to evaluate the cost, quality of care, and impact on maternal and fetal outcomes of using extramedical maternal health providers (doulas and lactation consultants) under the TRICARE program to determine the appropriateness of making coverage of such providers under the TRICARE program permanent.  Read the entire text of this legislation HERE.

FUNDING.

The following programs were funded in the FY2021 federal budget:

  1. Bringing Postpartum Depression Out of the Shadows Act ($5 million).  Funding will continue to provide grants to states to address maternal mental health.  Seven states (Florida, Georgia, Kansas, Louisiana, North Carolina, Rhode Island, and Vermont) will each receive a total of $3.2 million over the lifetime of the program (2019-2023).  Learn more HERE.
  2. Maternal Mental Health Hotline ($3 million).  Funding will be used to to establish and maintain a maternal mental health hotline to be staffed by qualified counselors, 24 hours a day. Funding may also be used for outreach to raise awareness about maternal mental health issues and the hotline.  Learn more HERE.

The 2020 Budget includes language requiring the Secretary of the Health and Human Services agency to convene agencies to determine what further role each should play in awareness, screening, diagnosis and treatment. The report must be issued to Congress by Wednesday June 17, 2020.

Maternal Mental Health.—The Committee is concerned that up
to 20 percent of new or expectant mothers will experience a maternal
mental health disorder during pregnancy or within the first
year after childbirth—such as depression, anxiety, or postpartum
psychosis. Untreated maternal mental health disorders negatively
impact the short and long-term health of affected mothers and
their children, with symptoms leading to adverse birth outcomes,
impaired maternal-infant bonding, poor infant growth, childhood
emotional and behavioral problems, and significant medical and
economic cost. The Committee directs the Secretary to submit a report,
in consultation with HRSA, SAMSHA, CDC, CMS, Office of
the Surgeon General, Office on Women’s Health, and Office of Minority
Health, to the Committees on Appropriations within 180
days of enactment of this Act on the role that each agency can take
to address gaps in maternal mental health public awareness,
screening, diagnosis and delivery for pregnant and postpartum
women.

With increased public attention to maternal mortality, members of the United States Congress have introduced several bills to provide additional resources for new mothers and to strengthen government agencies in their work addressing maternal mortality.  Learn more here.

In 2018, the initial round of funding ($5 million) was released and the Department of Health and Human Services (through the Health Resources and Services Administration) announced a competitive grant process for the states. Seven states (Florida, Kansas, Louisiana, Montana, North Carolina, Rhode Island, and Vermont) will each receive $3.2 million over the lifetime of the program (2019-2023).  Read the HRSA announcement.

In 2016, the United States Congress enacted the Bringing Postpartum Depression Out of the Shadows Act as part of the 21st Century Cures Act.  This law provides funding for programs addressing maternal mental health issues at the state level.  Read the entire text of the law.

In 2010, the United States Congress passed (but never funded) the MOTHER’S Act which called for research into the causes of and best treatments for postpartum depression, a public awareness campaign, a study on the benefits of screening for postpartum depression and psychosis, and a grant program to fund treatment services.  While The MOTHERS Act was never funded, it nevertheless was historically significant as it introduced language about postpartum depression into the federal legislative record and garnered support and interest across political parties.  Read the entire text of the law

Policy — State

Several states have taken steps to address maternal mental health (MMH) conditions by enacting legislation, requiring education and/or screening, and developing awareness campaigns.

  • States requiring screening women for maternal mental health (MMH) conditions include California, Florida, Illinois, New Jersey, Pennsylvania, Utah, and West Virginia.
  • States requiring educating healthcare providers and/or maternity patients include California, Minnesota, Oklahoma, Oregon, Pennsylvania, Texas, Utah, and Virginia.
  • States with public awareness campaigns include California, Colorado, Florida, Michigan, New York, Oregon, and Washington.
  • One state – Illinois – recognizes maternal mental health (MMH) conditions as a factor in criminal cases.

States that have Maternal Mental Health Awareness Day and/or Month  include:

Print Materials and Toolkits

The organizations listed below offer FREE comprehensive toolkits for addressing maternal mental health (MMH) conditions.

Professional Education and Development Opportunities

Advanced Training Programs February 2021

This document contains advanced training opportunities, such as those offered by Postpartum Support International, the Postpartum Stress Center, 2020Mom, and other nonprofit organizations addressing maternal mental health.

Postdoctoral Fellowships March 2021

This document contains a listing of postdoctoral fellowship programs throughout the United States.

Psychiatry Fellowship Programs February 2021

This document contains Psychiatry Fellowship Programs across the United States.

Psychiatry Access Programs

Psychiatry Access Programs build capacity to address maternal mental health issues by:

  • providing psychiatric consultation to front-line providers, such as obstetricians and family physicians, to help them treat women experiencing maternal mental health disorders
  • connecting affected women with additional resources for recovery, including therapists and support groups
  • providing one-on-one psychiatric consultation to women with complex maternal mental health issues

Lifeline4Moms is providing programmatic guidance and coordination among the organizations implementing maternal psychiatric access lines, including program development and implementation assistance, training and workforce development, consultation, evaluation and opportunities for collaborations with other health care organizations and states working to integrate perinatal mental health efforts in perinatal care.

These types of programs are patterned after successful psychiatry access programs for children and adolescents.  The National Network of Child Psychiatry Access Programs supports existing and emerging child psychiatry consultation programs and works to further national progress toward effective integration of mental health with primary care.

Interested in learning more?  The following documents are available to print and share widely:

Legislation

In 2016, the United States Congress enacted the Bringing Postpartum Depression Out of the Shadows Act as part of the 21st Century Cures Act.  This law provides funding, in the form of grants to the states, for programs addressing maternal mental health (MMH) conditions at the state level.  Read the entire text of the law.

Grant Process

The Health and Resources and Services Administration (HRSA), an agency of the Department of Health and Human Services, was charged with administering the grants funded through the 21st Century Cures Act.  In 2018, 30 states and the District of Columbia applied for these grants; seven states were each awarded 5-year grants (totaling $3.2 million for each state for the lifetime of the program).

Postpartum Support International offers a national Psychiatric Consult Line for medical professionals who have questions about the mental health care related to pregnant and postpartum patients and pre-conception planning.  Medical providers can request an appointment with highly-trained reproductive psychiatrists who are members of PSI.  Learn more HERE.

Lifeline4Moms is providing programmatic guidance and coordination among the organizations implementing maternal psychiatric access lines, including program development and implementation assistance, training and workforce development, consultation, evaluation and opportunities for collaborations with other health care organizations and states working to integrate perinatal mental health efforts in perinatal care.

The following states have (or are developing) psychiatry access programs.  States marked with (*) are HRSA grant recipients.

Screening

While mental health issues are the MOST COMMON complications of pregnancy and childbirth —  affecting approximately 1 in 5 women during pregnancy or the first year after being pregnant – these illnesses are often undiagnosed and untreated.

A childbearing woman will see a healthcare provider an average of 25 times during a routine pregnancy and first year of baby’s life.  However, no medical provider is required to screen her for mental health issues, and medical professionals often cite lack of knowledge, reimbursement, time, and resources for recovery as barriers to discussing these illnesses or screening for them.

The following national level medical organizations and governing bodies have issued statements encouraging medical providers to screen women for maternal mental health (MMH) conditions during pregnancy and after giving birth:

Medicaid reimburses screening for maternal depression on a state-by-state basis; learn more.

MMHLA is committed to creating a Gold Standard for screening maternal mental health (MMH) conditions at regular intervals during pregnancy and throughout first year of baby’s life.

Walks, Runs, Climbs

Postpartum Support International hosts Climb Out of the Darkness each year.  Learn more HERE.

Several states host runs & walks to raise awareness about maternal mental health issues, including:

Please provide updates and additional information to info@mmhla.org.