— Organizational Overview —
The National Coalition for Maternal Mental Health (NCMMH) was formed in 2014, bringing together the country’s leading voices addressing maternal mental health disorders – also referred to as perinatal mood and anxiety disorders, like postpartum depression – to create and implement uniform awareness campaigns, engage thought leaders and drive national advocacy and to provide hope and resources to women and their families who are impacted by postpartum disorders.
Member organizations include: 2020 Mom (Los Angeles, Calif.), Jenny’s Light (El Dorado Hills, Calif.), Junior League of San Francisco (San Francisco, Calif.), Maternal Mental Health Now (Los Angeles, Calif.), MotherWoman (Hadley, Mass.), Postpartum Health Alliance (San Diego, Calif.), and Postpartum Support International (Portland, Ore.).
According to the American Academy of Pediatrics, postpartum depression is the most common, yet most under-diagnosed, obstetrical complication in the country. Research suggests up to 20% of the approximately 4 million U.S. women who give birth each year will be affected by a maternal mental health disorder, including depression, bipolar disorder, anxiety and psychosis, which occur during pregnancy and up to one year postpartum. But even many doctors and other members of the medical community remain unfamiliar with the signs of maternal mental health concerns, and it is estimated that only about 15% of the 800,000 women who are suffering will get the help they need.
Maternal mental health disorders are not the “baby blues,” which impact up to 80% of women and includes unexplained tearfulness resulting from sharp changes in hormones. The blues resolve naturally within two weeks. While many women feel stigmatized by asking for help, disorders like postpartum depression are a legitimate medical concern with biological influences and generally require treatment. They may make it difficult for women to care for themselves or their family and put them at a significantly higher risk of suicide. In extreme cases of psychosis (which affects .1 to .2% of all new mothers), in which a woman may become delusional and paranoid, it can result in a mother taking her child’s life (infanticide). However, there is effective treatment and women do not need to suffer in silence.
Says Joy Burkhard, chair of NCMMH and director of Los Angeles-based 2020 Mom, “Postpartum depression can be very lonely and overwhelming, but there is help! For their own health and the sake of their family’s wellbeing during this important time, all women deserve to be screened, diagnosed and treated for maternal mental health disorders. While we have recently made positive strides, there is still a long way to go.”
Some of the more extreme cases of these treatable illnesses have become heart-breaking headlines in communities across the country … tragedies that could have been prevented. The risk for maternal suicide is significantly elevated among depressed perinatal women, and maternal suicides account for up to 20% of all postpartum deaths, making it one of the leading causes of maternal mortality in the perinatal period.
In October 2013, Pittsburgh-area resident Alexis Joy D’Achille, 30 – by all accounts a happy and vivacious woman with no history of depression – committed suicide just six weeks after the long-awaited birth of her daughter. Today, her husband, Steven, is a single dad and activist. Founder of the Alexis Joy D’Achille Foundation for Postpartum Depression, he has helped raise more than $350,000 to fund a new clinic to address maternal mental health at West Penn Hospital, one of four in the country where women and their babies are treated together. Recalls Steven about his wife’s efforts to get help, “For one reason or another, nobody took her serious. Nobody gave her the care that she deserved. How hard it is to admit you have a problem, go to professionals to try to seek that help and, every single time, be turned away … She just lost hope.”
Recalls Maureen Fura, Miami, who had no history of mental health issues and experienced postpartum depression with only the second of her three pregnancies, “I didn’t even know I was pregnant yet, but my thoughts started spinning out of control. I was thinking about suicide and having ‘What if …’ OCD thoughts, like ‘What if … I drove off a cliff?’ or ‘What if I poison my family with bleach?’ So I stopped doing laundry and I stopped driving beyond a perimeter of three miles around my home. I thought I’d be a better mother from afar and had to die. I didn’t think I would make it nine months.” But with the support of family, Fura – who spoke with 29 professionals before eventually finding appropriate treatment when six months pregnant – was able to find her way back. “I love being a mother,” says Fura, now a prominent advocate and filmmaker who told her story, as well as the stories of other mothers impacted by postpartum depression, in The Dark Side of the Moon. “I cherish every moment, because I am constantly aware that I almost wasn’t here.”
In January 2016, Carol Coronado, from the Los Angeles area, was sentenced to life in prison without the possibility of parole for stabbing to death her three daughters, ages 3 months, 16 months and 2 years old, in May 2014. Clinical examinations pronounced Coronado, then 29, to be suffering from postpartum psychosis at the time of the tragedy. Says her grieving husband, Rudy, who now realizes there were “signs” he didn’t understand, “I’m not a doctor but I know for a fact that it was the disease and not my wife, who wouldn’t have hurt anyone in a million years. That’s why we need to bring awareness to [postpartum mental illnesses]. I was never educated about anything like this … I didn't have a clue.”
Says Lynne McIntyre, former vice chair of NCMMH and a survivor of postpartum depressions and anxiety herself, “Screening, and the patient education that goes along with it, is key. When I recovered from my postpartum depression and anxiety, my husband told me he felt like he had been living with a stranger for months. I was completely unrecognizable to myself, my partner and my family. But, since no one in the healthcare community mentioned anything like postpartum depression, we all suffered for far too long.”
“[It] has impacted every aspect of my life,” says Hayden Panettiere, describing the effects of postpartum depression in a recent interview with People magazine. The television star has been very vocal about her ongoing struggle after the birth of her daughter, Kaya, in December 2014, even having producers write it into the storyline of her show, Nashville.
While activists and survivors agree that there is much work to be done, there has been recent progress …
On Jan. 26, 2016, the United States Preventative Services Task Force (USPSTF), which sets forth guidelines around preventive and diagnostic screening, announced its recommendation that pregnant and postpartum women should be routinely screened for depression. The USPSTF further recommended that mothers with positive screening results – utilizing such standardized instruments such as the Patient Health Questionnaire or the Edinburgh Postnatal Depression Scale – should receive additional assessment for severity of depression, comorbid conditions and alternative diagnoses.
The USPSTF is an independent, volunteer panel of national experts in prevention and evidence-based medicine, which works to improve the health of all Americans by making recommendations about clinical preventive services such as screenings, counseling services and preventive medications. They found convincing evidence that screening for maternal mental health issues (during and after pregnancy) improves accurate identification of adults with depression in primary care settings.
In May 2016, NCMMH held an Advocacy Day on Capitol Hill in support of two bills addressing these issues and is continuing to lobby to garner additional support for the Bringing Postpartum Depression Out of the Shadows Act. House of Representatives Bill #HR3235, introduced by Congresswoman Katherine Clark (D-MA), and the companion Senate Bill #S2311, introduced by Senator Dean Heller (R-NV), call for an amendment to the Public Health Service Act to authorize the Secretary of Health and Human Services to make grants to states for screening and treatment for maternal depression. The bi-partisan bills – which are supported by 63 members of Congress to date – call for the federal government to provide $5 million annually for four years, 2016-2020, to states to support their actions in finding “innovative solutions” to this pervasive problem.
You can help by sending you congressional representative a letter and asking them to support these important bills. Learn more at https://2020mom.salsalabs.org/21stcenturycuresactlettertocongress/index.html
And there are showcase resource programs being launched, like the Massachusetts Child Psychiatry Access Program (MCPAP for Moms) and Washington, D.C.’s Mental Health Access in Pediatrics (DCMAP), two initiatives that work and should be emulated by others. MCPAP for Moms and DCMAP promote maternal and child health by building the capacity of providers serving pregnant and postpartum women and their children (up to one year after delivery) to effectively prevent, identify and manage depression.
Need help or know someone who does?
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About NCMMH’s Member Organizations …
2020 Mom — Los Angeles, Calif. — Founded in 2011 as the California Maternal Mental Health Collaborative, 2020 Mom has evolved as a national organization with a mission of closing gaps in maternal mental care through education, advocacy and collaboration. www.2020mom.org
Jenny’s Light — El Dorado Hills, Calif. — Created in honor of Jenny and Graham Gibbs, the mission of Jenny’s Light is to improve and save lives by increasing awareness of all perinatal mood disorders, including postpartum depression. They also aim to reduce the stigma of maternal mental health complications so that mothers can safely talk about how they may be feeling. www.jennyslight.org
Junior League of San Francisco — San Francisco, Calif. — Supports the right of all women to equal treatment and opportunity under the law and advocates for social, economic, health, cultural and educational opportunities for all persons. As a problem surfaces within the community, the JLSF is frequently the first organization to recognize and address the issue, providing volunteer energy, financial assistance and public support. Often in collaboration with other community groups and/or the public sector, the JLSF designs and launches a program, then works to achieve community impact and measurable results. www.jlsf.org
Maternal Mental Health Now — Los Angeles, Calif. — The non-profit’s mission is to remove barriers to the prevention, screening and treatment of prenatal and postpartum depression in Los Angeles County. They provide a directory of patient resources and also train healthcare workers on what to look for when diagnosing potential maternal mental health disorders. www.maternalmentalhealthnow.org
MotherWoman — Hadley, Mass. — Adresses the socio-economic issues facing American mothers by advocating for family friendly policy, seeks to create a culture that understands and de-stigmatizes screening and treatment of perinatal emotional complications, promotes evidence-informed models in prevention, detection and treatment by addressing barriers to care. The on-profit also trains medical and mental health professionals, as well as support group facilitators, within various Massachusetts communities to implement this vision. www.motherwoman.org
Postpartum Health Alliance — San Diego, Calif. — Postpartum Health Alliance is a non-profit organization dedicated to raising awareness about perinatal mood and anxiety symptoms and disorders, providing support and treatment referrals to women and their families in the San Diego area. www.postpartumhealthalliance.org
Postpartum Support International — Portland, Ore. — Promotes awareness, prevention and treatment of mental health issues related to childbearing in every country worldwide, including volunteer coordinators in every one of the United States and in more than 36 other countries. Founded in 1987 by Jane Honikman, the organization increases awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum. Its goal is to provide current information, resources and education and to advocate for further research and legislation to support perinatal mental health. www.postpartum.net
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