Program provides resources for perinatal & postpartum mental health
The birth of a child can be one of life’s most miraculous, joy-filled events. For many new mothers, however, the time around giving birth can be less than positive. In fact, each year one in five pregnant women experience mental health or substance use disorders during pregnancy or in the postpartum period.
“This is a leading cause of death and it is far too common,” said Nancy Byatt, DO, MS, MBA, founder and director of the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms). “Even beyond maternal mortality, these things have a negative impact on the parent, on infant outcomes, and on pregnancy outcomes.”
In the early 2010s, while doing research on the topic, Byatt saw gaps in care for perinatal and postpartum individuals. Using the decade-old Massachusetts Child Psychiatry Access Program (MCPAP) as a model, she developed MCPAP for Moms to provide mental health resources and referrals for providers in medical settings.
“Obstetricians are at the front line and don’t necessarily have the training or the skill set or confidence to address mood and anxiety or substance use disorders,” she said, “I saw the MCPAP model for children and thought we could have a similar model, whereby we can train perinatal care providers to build their capacity to address mental health and substance use disorders among pregnant and postpartum individuals.”
Since its inception, MCPAP for Moms has enrolled 177 practices and 1,7834 practitioners, serving more than 22,000 people. Over that time, Byatt has noticed a real shift in how their outreach has been accepted.
Where colleagues once warned her that the medical community would not accept guidance in mental health care, she is now seeing practitioners including mental health discussions and treatment in their daily care regimen.
“There has been a major cultural shift within the field of obstetrics around mental health,” she said. “Ob clinicians are now expected to screen, assess, treat, and follow up, which wasn’t the case 10 years ago.”
Research has shown improved outcomes resulting from the program, with increased quality of care and reduced depression and anxiety in patients. This success has raised awareness across the country, inspiring the creation of 29 similar state programs, including ones in Vermont, Connecticut, and Rhode Island in New England.
“The model has gone far beyond what we created in Massachusetts,” said Byatt. “They are creating their own innovations and program components. We are all learning from each other now, which is great.”
While some may question a program aimed at encouraging medical professionals to prescribe and monitor psychiatric medicines and treatment, Byatt points out that a dearth of mental health providers severely hinders treatment.
“If we could refer everyone to a psychiatric clinician, that would be wonderful,” she said. “It’s not going to happen in any of our lifetimes especially as obstetrics settings are screening and detecting even more illness.”
Instead, she added, it is more expedient to find innovative ways to ensure treatment happens once need is identified, since follow up treatment after screenings is extremely low.
“The best thing we can do as a society and as a health care system is to help them get the treatment and support that they need and deserve,” Byatt said.