What is the U.S. doing to improve perinatal mental health care?


In the U.S., there is no federal law or mandate for screening mothers during the pregnancy and postpartum period. The states each have various ways that they approach things – each individual institution, each individual physician. Like Canada, on a national level, advocates are working hard to create a federal mandate and strategy.

On June 29th, 2021, Congressman Larry Bucshon M.D. (R-Ind.) introduced a bipartisan bill to protect the mental health of new mothers by increasing prevention, screening, diagnosis, intervention, treatment, and access to care for maternal mental health conditions.

The bill is titled the “Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health for New Moms Act of 2021’’ or the ‘‘TRIUMPH for New Moms Act of 2021.”

The Taskforce would create and regularly update a report to identify, analyze, and evaluate the state of national maternal mental health policy and programs at the federal, state, and local levels. The Taskforce would identify best practices, including strategies and recommendations to eliminate the racial and ethnic disparities that exist in maternal mental health.

The Taskforce would also develop and regularly update a national strategy for maternal mental health, including how federal departments and agencies represented on the Task Force will address maternal mental health conditions including increasing prevention, screening, diagnosis, intervention, treatment, and access to care.

This follows the 2016 Bringing Postpartum Depression Out of the Shadows Act brought forward by Rep. Katherine M. Clark (D-Mass.) which passed in the House of Representatives and the Senate. The bill authorized the Secretary of Health and Human Services to provide federal grants to states for the purpose of screening, assessing and treating postpartum depression. The grants are allowing states to create, improve or maintain programs around maternal mental health and help women who are pregnant or recently gave birth.

Around 2008-2009, perinatal mental health in the U.S. started to become an issue in state legislatures as they saw a rise in of infants being born substance use addicted and an increase in teen pregnancy. And there was a direct connection to the mental health and wellness of birthing people.

State legislatures like West Virginia started implementing screening into their Medicaid systems. States like Massachusetts formalized a commission identifying the causation of postpartum depression, and it’s now the Ellen Story Commission on Postpartum Depression.

These state level discussions prompted a deep dive into data, and from there, these data points were brought to federal legislators on Capitol Hill, and in 2016, maternal mental health legislation was passed and fully funded to put monies into states for telepsychiatry access programs that allow whatever clinician a mom interfaces – pediatrician, GP – to speak with their clinicians and allow the clinician, even if they’re not experts in perinatal mental health, to pick up the phone and identify support for those moms.

Ten states have launched commissions or task forces.

New York Governor Andrew Cuomo signed into law the Maternal Depression Bill on August 4, 2014. One component of the bill requires written guidelines to be distributed to healthcare providers about screening women for depression during and after pregnancy.

New Jersey is one of three states (along with Illinois and West Virginia) that requires screening. In New Jersey, the law mandates that an obstetrician, nurse, or midwife screen women before they leave the hospital after giving birth and at several postpartum visits.

Read more about the new TRIUMPH Bill here: https://www.prnewswire.com/news-releases/triumph-for-new-moms-act-to-build-strategy-for-improved-mental-health-of-us-mothers-301322558.html

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