Dear John,

Building on our successful October 2021 issue on Perinatal Mental Health, the April issue of Health Affairs returns to the topic.

In an opening article, Emily Dossett and colleagues note growing attention to perinatal mental health and offer seven policy proposals “designed to advance perinatal mental health for all people, especially those living with trauma, inequity, and barriers to care.”

Alison Stuebe and colleagues discuss the vital conditions necessary to “move toward well-being and reproductive justice.”

Burden Of Poor Mental Health

Sarah Haight and coauthors explore racial and ethnic disparities in postpartum depressive symptoms and diagnosis.

Using data from seven participating health departments, they find no significant differences in rates of diagnosis by race or ethnicity but significantly lower rates of receiving postpartum mental health care among people who identify as a member of a racial or ethnic minority group.

Slawa Rokicki examines the association between depressive symptoms at delivery and infant emergency department (ED) use in the first year of life in New Jersey, a state with universal maternal depression screening after birth.

Infants of mothers with moderate-to-severe symptoms had 21 percent more ED visits than infants of mothers with no symptoms.

Kara Zivin and coauthors document a near-doubling in the rate of perinatal mood and anxiety disorder (PMAD) diagnoses among people with commercial health insurance between 2008 and 2020.

Stephanie Hall and coauthors find an almost quadrupling of rates of posttraumatic stress disorder diagnoses among the same population during the same period.

Improving Access And Care

Constance Guille and colleagues evaluate the efficacy of a text- and telephone-based screening and referral program for perinatal mental health disorders.

Program recipients were “more likely to be screened, screen positive, be referred to treatment, and attend treatment” than those who received traditional in-person screening and referral.

Through a series of interviews and ethnographic observations, Jessica Harrison documents clinicians’ perspectives on mental health integration in perinatal care.

Harrison uncovers challenges raised by mental health and perinatal health clinicians in achieving the type of integration often held up as the model for high-quality care.

Sarah Gordon and coauthors use a natural experiment in Colorado as the basis for understanding the effects of extending postpartum Medicaid coverage from sixty days to a full year.

They find that retaining coverage is associated with “increased rates and continuity of outpatient mental health and prescription medication treatments for PMAD compared with switching to commercial insurance.” Perinatal psychiatry access programs are designed to support obstetric practices in their efforts to address perinatal mental health needs.

Ana Schaefer and colleagues examine existing programs and survey program leaders. They conclude that the programs “provide a promising scalable approach to addressing the lack of access to high-quality perinatal mental health care in the US.”

Analyzing commercial insurance data, Stephanie Hall and coauthors find an increase in postpartum antidepressant prescribing subsequent to clinical recommendations supporting such behavior issued in 2015 and 2016.

Meeting Population Needs

Karissa Fenwick and coauthors interview women with serious mental illness (SMI) to understand their pregnancy and parenting experiences and preferences.

The authors find “critical gaps in information, support, and resources related to pregnancy planning, the potential teratogenicity of psychotropic medication, and parenting in mental health services.”

Using data from a social determinants screener deployed in a safety-net health system, Bridgette Blebu and coauthors explore the social context of pregnant clients with PMAD or SMI.

One-quarter of clients reported adverse social factors across two or more domains that include housing instability, food insecurity, intimate partner violence, low social support, and familial substance use.

Sandraluz Lara-Cinisomo and coauthors identify COVID-19 pandemic-related stressors experienced by perinatal women and mothers of young children of Mexican descent. The themes identified through interviews centered on food access, mental health, and health and safety.

Amy Stiffarm and colleagues describe perinatal mental program development using a collaborative approach with Tribal communities in Montana.

Health Affairs Branded Post:

Thom Bales

Sponsored by PwC

The April 2024 issue of Health Affairs focuses on the topic: “Perinatal Mental Health & Well-Being.”

Building on the success of our October 2021 issue on perinatal mental health, the new issue expands the focus on equity, justice, and well-being.

You are invited to join us on Wednesday, April 3, from 1:00 p.m. to 4:00 p.m. (Eastern), for a virtual forum at which authors will present their work, engage in discussions, and answer questions on important issues.

Find out more and register below!

For our theme issue on Perinatal Mental Health & Well-Being, eleven authors filmed a video version of their abstracts.

These video abstracts are available with open access on the article's pages and on our YouTube channel (Please subscribe!).

Check out the video abstracts below:

• Craig F. Garfield and Tova B. Walsh Perinatal Mental Health: Father Inclusion At The Local, State, And National Levels
• Nichole Goodsmith Addressing Pregnancy And Parenting In Mental Health Care: Perspectives Of Women With Serious Mental Illness
• Sarah Gordon Extended Postpartum Medicaid In Colorado Associated With Increased Treatment For Perinatal Mood And Anxiety Disorders
• Stephanie V. Hall Antidepressant Prescriptions Increased For Privately Insured People With Perinatal Mood And Anxiety Disorder, 2008–20
• Slawa Rokicki Perinatal Depression Associated With Increased Pediatric Emergency Department Use And Charges In The First Year Of Life
• Ana Schaefer Increasing Access To Perinatal Mental Health Care: The Perinatal Psychiatry Access Program Model
• Amy Stiffarm A Strategy To Support Perinatal Mental Health By Collaborating With Tribal Communities In Montana
• Alison M. Stuebe Cultivating Vital Conditions For Perinatal Well-Being And A Sustained Commitment To Reproductive Justice
• Karen Tabb Dina Perinatal Mental Health: The Need For Broader Understanding And Policies That Meet The Challenges
• Kara Zivin Perinatal Mood And Anxiety Disorders Rose Among Privately Insured People, 2008–20

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