Bridging Access Challenges for Maternal Mental Health in California
There must be something in the water in Beacon Health Options’s San Francisco office. Over the past year, several of us who share the space have had baby girls (me included). As an expectant and now new mom, I have experienced the health care system as a patient – not just as a behind-the-scenes professional.
At my first postnatal appointment, the nurse checking me in handed me a clipboard with some familiar questions – an Edinburgh scale to measure my risk for postpartum depression. While I often chuckle at how slowly technology has been to enter the clinical workflow, especially in San Francisco, I was glad to see that my OB-GYN was taking the question of maternal mental health seriously.
System stakeholders focus on maternal mental health
The good news is that my doctor’s office is part of a growing focus in California by clinicians, funders, advocacy groups, health plans and now state legislators on maternal mental health, starting with screening. Advocacy groups such as Maternal Mental Health Now and 2020 Mom have prepared reports on the issue and have designed clinician trainings. Funders such as the David & Lucile Packard Foundation have looked at how technology can play a role (I helped contribute to this effort, with a mobile mood reporting app), and groups such as the California Health Care Foundation are looking to incorporate mental health into their broader focus on maternal well-being. There has even been legislative activity advocating for support and programs for women.
Furthermore, maternal mental health is very much an issue of geography. Research by Dr. Jennifer Rienks of the Family Health Outcomes Project at University of California, San Francisco, shows that there is a growing regional disparity, with higher mental health diagnosis rates in the more rural parts of the state. Therefore, any solution needs to leverage new tools and models for under-resourced regions as well.
MCPAP for Moms
From Beacon’s perspective, and from my experience as a new mom, screening is only effective when there are resources to support women at risk for, or diagnosed with, a postpartum mental health condition. The good news is that Beacon has a great model from our Massachusetts colleagues, where Dr. John Straus, Beacon Associate Medical Director, and Dr. Nancy Byatt, Associate Professor of Psychiatry, OB/GYN, and Quantitative Health Sciences at the University of Massachusetts Medical School, have expanded the original Massachusetts Child Psychiatry Access Program (MCPAP) to OB-GYNs through MCPAP for Moms. The program provides real-time psychiatric consults to primary care physicians, pediatricians and OB-GYNs through a series of hubs staffed with a psychiatrist, a care coordinator, and a navigation support professional.
From Beacon’s perspective, and from my experience as a new mom, screening is only effective when there are resources to support women at risk for, or diagnosed with, a postpartum mental health condition.
Beacon has adapted the MCPAP model into our new Cal Consults program. We are working with many of the stakeholders above to launch our first maternal health hub in 2019. We are fortunate to have partners who believe in this model and the potential to expand services by making the next step after a screening as easy as a consultative phone call. Beacon’s California team is excited about these efforts, and is hopeful that, by the time the next Beacon baby is born in San Francisco, follow-up screening will be not only a form but an action plan and complement of services too (and maybe even a mobile app)!
Interested in learning more? Dr. Rienks and Dr. Straus will be presenting on the state of maternal health in California and the MCPAP for Moms model during a webinar on May 16th. Learn more and register here.