Since the early 2000s, awareness about maternal mental health issues has grown exponentially:
- Hundreds of articles and stories about maternal mental health have been featured in print and digital media and on radio and television.
A search on the blog “Motherly” in September 2019 included 150+ articles about maternal mental health challenges.
- Scores of books and academic articles about maternal mental health have been published.
A search on Amazon in January 2019 returned a list of over 100 books addressing postpartum depression, the majority published since 2010 (and almost 20 published in 2019).
- Two documentary movies, a full-length feature film, and several television series have addressed maternal mental health challenges.
Actress Brooke Shields – who wrote about her experience with postpartum depression in “Down Came the Rain” – was the executive producer of one of the documentaries.
- Celebrities and athletes who have experienced postpartum depression or anxiety have spoken publicly and shared their struggles on social media.
Celebrities who have spoken openly about their challenges include singer Adele, model and author Chrissy Tiegen, and tennis superstar Serena Williams.
- Families affected by maternal mental health challenges have launched non-profit organizations, websites, fundraisers, and awareness events.
Advocates and survivors have banded together to raise money to address maternal mental health and to educate elected officials through coalitions, task forces, and advocacy days at the local, state, and federal level.
MMHLA is committed to harnessing this energy and enthusiasm to create meaningful change at the federal level and to provide advice, guidance, and lessons learned to those at the state and local levels.
2020 Policy Efforts
ACTIVITIES INITIATED BY MMHLA
2nd Annual CONGRESSIONAL BRIEFING on the Status of Maternal Mental Health (May 19, 2020). MMHLA — in partnership with the March of Dimes — hosted a VIRTUAL Congressional briefing with almost 450 participants. Learn more about and watch the briefing HERE.
LETTER to Senate Leadership Encouraging Extending Pregnancy Medicaid (October 28, 2020). MMHLA authored a letter (co-signed by over 100 organizations) encouraging the United States Senate to enact legislation extending Medicaid for eligible new mothers for a full year postpartum.
LETTER to Senate Appropriations Committee Leadership Regarding Maternal Mental Health Hotline (September 8, 2020). MMHLA authored a letter (co-signed by over 125 organizations) requesting the Senate Appropriations Committee support funding a maternal mental health hotline at $3.5 million.
LETTER to Senators Bluementhal and Kaine Endorsing S.3809 (July 7, 2020). MMHLA authored a letter (co-signed by sister organizations 2020Mom and Postpartum Support International) endorsing S.3809, the Military Mothers Mental Health Assessment Act.
LETTER to Representatives Kennedy and Underwood Endorsing H.R.6143 (July 7, 2020). MMHLA authored a letter (co-signed by sister organizations 2020Mom and Postpartum Support International) endorsing H.R.6143, the Moms MATTER Act of 2020.
LETTER to Senate and House Leadership Regarding Screening and Treatment of Maternal Depression (June 25, 2020). MMHLA authored a letter (co-signed by over 30 organizations) to Senate and House leaders requesting additional funding for HRSA grants to states to create programs to address maternal depression.
LETTER to House Energy and Commerce Committee Regarding 21st Century Cures Act 2.0 (June 24, 2020). MMHLA authored a letter (co-signed by sister organizations 2020Mom and Postpartum Support International) encouraging funding programs to address maternal mental health.
LETTER to the Directors of the NIH and FDA Regarding Diversity in COVID-19 Research (June 15, 2020). MMHLA authored a letter encouraging including women in COVID-19 research and clinical trials.
LETTER to House Appropriations Leadership Regarding Screening and Treatment of Maternal Depression (May 1, 2020). MMHLA authored a letter (co-signed by over 30 organizations) requesting additional funding for HRSA grants to states to create programs to address maternal depression.
ACTIVITIES SUPPORTED BY MMHLA
LETTER to Health and Human Services Secretary Azar (December 18, 2020). MMHLA supported a letter (drafted by the National Association for Behavioral Healthcare) providing thoughts about COVID-19 vaccinations for essential personnel.
LETTER to Congressional Leadership Encouraging Passage of Legislation Addressing Maternal Mortality (December 4, 2020). MMHLA supported a letter (drafted by AMCHP) encouraging Congress to pass the bipartisan Maternal Health Quality Improvement Act (H.R. 4995) and the bipartisan Helping MOMS Act of 2020 (H.R. 4996).
LETTERS to Governors Addressing Telemental Health Coverage (October 20, 2020). MMHLA supported a letter from the Mental Health Liaison Group encouraging states to extend telemental health coverage for commercial plans remain through 2021. Letters were sent to the following states that do not have a telelemental health mandate in place: Alabama, Florida, Idaho, Louisiana, North Carolina, Pennsylvania, South Carolina, Wisconsin, and Wyoming.
LETTER to Centers for Medicaid and Medicare Services Regarding Telehealth (October 5, 2020). MMHLA supported a letter from the Mental Health Liaison Group supporting expanding telehealth, and strongly urging allowing telehealth through audio-only devices and the elimination of cutrent geographic and site restrictions.
LETTER to U.S. Senators Sullivan and Rosen (September 25, 2020). MMHLA supported a letter from the Mental Health Liaison Group supporting S4211, the Facilitating Reforms That Offer Necessary Telehealth In Every Rural (FRONTIER) Community Act.
LETTER to House Leadership Regarding the Dr. Lorna Breen Healthcare Provider Protection Act (September 24, 2020). MMHLA supported a letter from the Mental Health Liaison Group supporting H.R.8094, the Dr. Lorna Breen Healthcare Provider Protection Act, aimed at reducing mental health burnout among healthcare providers.
LETTER to Centers of Medicaid and Medicare Services (August 10, 2020). MMHLA supported a letter (drafted by sister organization 2020Mom) regarding Postpartum and Prenatal Depression Core Set Measures.
LETTER to Congressional Leadership Regarding Extending Medicaid (July 23, 2020). MMHLA supported a letter (drafted by American College of Obstetricians and Gynecologists) encouraging extending Medicaid Insurance for eligible mothers for a full year postpartum.
LETTER to House Leadership Regarding National Suicide Hotline (July 22, 2020). MMHLA supported a letter from the Mental Health Liaison Group encouraging the House to vote on S2661 to implement “988” as the 3-digit National Suicide Prevention Lifeline.
LETTER to Senate Leadership Regarding Federal Medical Assistance Percentage (June 25, 2020). MMHLA supported a letter from the Mental Health Liaison Group encouraging increasing FMAP.
LETTER to Senate Leadership Regarding Coronavirus Phase 4 Funding (June 22, 2020). MMHLA supported a letter from the Mental Health Liaison Group encouraging expanding infrastructure for mental health and substance use services and support.
LETTER to Congressional Leadership Regarding Coronavirus Phase 4 Funding (May 8, 2020). MMHLA supported a letter (drafted by March for Moms and Every Mother Counts) encouraging implementing policies to ensure that all families are kept safe during the COVID-19 pandemic.
LETTER to Congressional Appropriations Leadership Regarding Screening and Treatment of Maternal Depression (March 24, 2020). MMHLA supported a letter (drafted by American Academy of Pediatrics) encouraging funding $8 million for HRSA grants to states to create programs to address maternal depression. Letter also included funding request for child psychiatry access programs.
LETTER to NIH and FDA Regarding COVID-19 and Pregnant / Lactating Women (March 18, 2020). MMHLA supported a letter from the CAMT encouraging including pregnant and lactating women in COVID-19 research and clinical trials.
In addition, MMHLA is a member of the Mental Health Liaison Group, a coalition of national organizations representing consumers, family members, mental health and addiction providers, advocates, payers and other stakeholders committed to strengthening Americans’ access to mental health and addiction care
2019 Policy Efforts
1st Annual Congressional Briefing on the Status of Maternal Mental Health (May 3, 2019). MMHLA Founder Jamie Belsito and MMH advocate Valerie Wilson discussed the state of maternal mental health in light of maternal mortality statistics.
LETTER to House regarding MIECHV Early Home Visiting Programs (December 10, 2019). MMHLA supported a letter to reauthorize MIECHV Early Home Visiting Programs.
LETTER to Senate Appropriations Leadership Regarding HHS Interagency Report (May 30,2019). MMHLA supported a letter to Senate leadership requesting an interagency report by the Department of Health and Human Services on the role each agency plays in addressing maternal mental health.
- 2020: Federal legislation (through the National Defense Authorization Act).
- Military Moms 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.
- TRICARE Coverage for Doula 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.
- 2020: Federal funding.
- 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, Kansas, Louisiana, Montana, 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.
- 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.
- 2019: President’s budget. The President’s 2020 Budget included 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.
- 2018: Federal funding. In 2018, the initial round of funding for Bringing Postpartum Depression Out of the Shadows Act 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. Thirty states and the District of Columbia applied for these grants; however, due to limited funding of $5 million, only seven states (Florida, Kansas, Louisiana, Montana, North Carolina, Rhode Island, and Vermont) were awarded grants to implement programs addressing maternal mental health. Read the HRSA announcement.
- 2016: Bringing Postpartum Depression Out of the Shadows Act. 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.
- 2010: The MOTHERS Act. 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
Several states have taken steps to address maternal mental health (MMH) issues by enacting legislation, requiring education and/or screening, and developing awareness campaigns.
- States requiring screening women for maternal mental health (MMH) conditions include California, Illinois, New Jersey, Pennsylvania, and West Virginia.
- States requiring educating healthcare providers and/or maternity patients include California, Minnesota, Oregon, Pennsylvania, Texas, and Virginia.
- States with public awareness campaigns include California, Colorado, Florida, Michigan, Oregon, and Washington.
- States that have Maternal Mental Health Awareness Day and/or Month include Arizona, California, Illinois, and Virginia.
- One state – Illinois – recognizes maternal mental health issues as a factor in criminal cases.
Several states (and the District of Columbia) have task forces addressing maternal mental health (MMH).
- Colorado: Colorado Maternal Mental Health Collaborative
- District of Columbia: DC Collaborative for Mental Health in Pediatric Primary Care
- Maine: Maternal Mental Health Alliance of Maine
- Massachusetts: The Ellen Story Commission on Postpartum Depression
- Maryland: Task Force To Study Maternal Mental Health
- Oregon: Public Health Initiative for Perinatal Depression
- Utah: Utah Maternal Mental Health Collaborative
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 30 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 issues during pregnancy and after giving birth:
- American Academy of Pediatricians
- American Academy of Family Physicians
- American College of Obstetricians and Gynecologist
- Association of Women’s Health, Obstetric, and Neonatal Nurses
- United States Preventive Services Task Force
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.
The economic costs and considerations of maternal mental health (MMH) conditions are significant, and include the cost of untreated illnesses and the impact on the baby and family. The following organizations have examined the economic costs and long-term implications of MMH conditions:
- Mathematica (2019): Societal Costs of Untreated Perinatal Mood and Anxiety Disorders in the United States
- The Brookings Institute (2019): The Effects of Maternal Depression on Early Childhood Development and Implications for Economic Mobility
- The Rand Corporation (2013): Transforming Systems for Parental Depression and Early Childhood Developmental Delays
- The Wilder Foundation (2010): The Cost of Untreated Maternal Depression
The National Committee for Quality Assurance — with assistance from the ZOMA Foundation and the California Healthcare Foundation — has developed care quality measures around screening for depression during pregnancy and the postpartum period. These measures are now included in the national Healthcare Effectiveness Data and Information Set (HEDIS), which includes measures for physicians, insurance providers, and other organizations. Learn more here: NCQA Perinatal Depression Measures.