New Resource Spotlights Maternal Mental Health

Suicide and fatal drug overdoses are the leading causes of death for childbearing people in the year after delivery, yet finding mental health care while pregnant often represents an insurmountable hurdle. Obstetricians frequently do not want to treat patients for mental illness, while mental health professionals often feel unequipped to treat patients during pregnancy.

To meet the needs of mental health professionals who are treating pregnant patients, APA has designed a new toolkit with support from a Centers for Disease Control and Prevention (CDC) Foundation grant. The Perinatal Mental Health Toolkit aims to place maternal mental health front and center for a wider audience not only by identifying gaps in medical training, but also by increasing the level of confidence among clinicians in providing care to this population, said Ludmila De Faria, M.D., chair of APA’s Committee on Women’s Mental Health.

“Maternal mental health is hugely important because you are improving two people’s lives: parent and child,” De Faria said. “If the parent is struggling with mental illness or substance use, the child is starting life with a handicap.” De Faria also pointed to the timeliness of the project, as recent legal restrictions around family planning may inadvertently result in an increase in unplanned pregnancies (Psychiatric News, “APA Responds to End of Roe v. Wade”).

The toolkit’s development was informed by a 21-member advisory panel of psychiatrists and other clinicians with expertise in maternal mental health. Jonathan Alpert, M.D., Ph.D., was the panel’s chair, and De Faria served as vice chair. The advisory panel also included representatives from the American Psychological Association, American Association of Nurse Practitioners, American Counseling Association, and National Association of Social Workers.

“The lack of access to mental health care is a widespread problem, not only for pregnant persons but for the population in general,” De Faria said in an email. “But when pregnant persons do access care, it is important that the provider—prescribers and nonprescribers alike—have the knowledge and resources to care for them. The multidisciplinary advisory panel identified that the lack of training and familiarity with available resources has played a significant part in compounding the problem.”

The toolkit includes eight fact sheets for both clinicians and patients, a white paper, and a four-part webinar series. The white paper and webinars cover the following topics:

• The epidemiology and biology of perinatal mental health and substance use disorders, as well as how these conditions impact maternal and child outcomes.

• The clinical management of perinatal mental health and substance use disorders, including both pharmacological and nonpharmacological interventions.

• Training gaps in perinatal mental health care education.

• Considerations that clinicians should keep in mind for certain vulnerable populations, such as adolescents, those who identify as a sexual or gender minority, refugees, and victims of intimate partner violence.

Additionally, the white paper calls for revisions to academic and continuing education curricula including psychiatry residency programs to improve competency and confidence within the mental health workforce while treating pregnant and postpartum patients.

De Faria said she hopes all mental health professionals begin to understand the importance of addressing perinatal mental health and substance use disorders to ensure the health of all parents and children. ■