LA
Best Babies Network, in partnership with the
Los Angeles County Perinatal Mental Health Task Force, recently hosted the first Perinatal Depression Policy
Roundtable. The Roundtable was convened as a call to action to improve and increase screening and
treatment resources for perinatal mood disorders in Los Angeles County. More than 30 committed perinatal stakeholders
gathered to identify perinatal mental health policy solutions and thereby
begin to develop a policy agenda for L.A. County. The Roundtable and the policy
agenda are funded by a five-year Community Opportunities Fund policy and
advocacy grant from First 5 LA.
Maternal depression is a
significant public health concern affecting countless women, infants, and their
families in the County. It is associated with substance abuse, premature
delivery, low-birthweight babies, shorter duration of breastfeeding, and
disruption of the mother-infant bond. In its most extreme form, it can be
life-threatening to mothers and children.
Community clinic
directors and county and state mental health agency members were welcomed by
Dr. Lynn Yonekura, LA Best Babies Network's executive director. She was followed by
a powerful video presentation of Kimberly Wong, Esq., Chair of the Perinatal
Mental Health Task Force of Los Angeles County, testifying earlier this year before the California
State Assembly, about her personal struggle with postpartum
depression.
Harding cited some alarming
statistics from the Network's recently published
Landscape Report on Maternal Depression in Los Angeles County. Sadly, half of the women
suffering from perinatal depression in the County are never diagnosed. And low-income
women, Latinas, and African American mothers are at greatest risk for maternal depression.
Harding emphasized that perinatal depression is highly treatable, and that all
women should be screened.
"There are a lot of missed
opportunities," said Harding, adding that, all too often, new mothers don't ask
for help, because they are afraid or ashamed to admit they are not enjoying
their new baby, or because cultural stigma prevents them from acknowledging
mental health issues. Some women might even be afraid that their child will be
taken from them.
Another recurring theme was the general
reluctance on the part of providers to screen for maternal depression. Barriers
to screening include lack of reimbursement by Medi-Cal, self-reported lack of
qualifications, and in particular, the worry that should a woman screen
positive for depression, there would be nowhere to refer her, and the provider
would then become responsible for her care.
Harding cited the "great work" of
the Network's
Care Quality Collaborative, which, through training in evidence-based
practices and diligent measuring of improvement, has dramatically increased its
depression screening rates.
Participants later broke into
smaller work-groups to brainstorm policy solutions in four areas:
Access,
Financing, and Standards of Care
Education
and Training of Providers
Public
Awareness, Education, and Social Support
The Mental
Health Workforce
Janice French, CNN, MS, the Network's director
of programs, said of the Care Quality Collaborative, "When we asked providers
to make it a goal to screen every woman in every trimester, some were aghast. But
we started small and slowly, so that no one was going to be over-burdened by
referrals."
The
work has paid off in both measurable and incalculable ways. She told the story
of two separate Care Quality clinics that, through screening, both identified a
patient who was depressed to the point of having made a suicide plan. Were it
not for the depression screening these clinics had in place, both of these women
would have gone undiagnosed, and lives may have been lost. "This is a very
powerful reinforcement," said French.
Additional
funding for the Roundtable and the policy agenda come from The California
Endowment, The California Wellness Foundation and the California Community
Foundation.
See additional photographs from the Roundtable here.
