The National Healthy Mothers, Healthy Babies Coalition

Transcription

1 The National Healthy Mothers, Healthy Babies Coalition in celebration with U.S. Department of Health and Human Services, Office of Women s Health presents Paying Attention to Maternal Mental Health Before, During and After Pregnancy Susan Dowd Stone, MSW, LCSW May 16, 2012

2 Additional Resources Organization of Teratology Information Specialists rral-f

3 Postpartum Partners Monday night chat with the Experts for men Dr. Will Courtenay s website

4 Challenges to Perinatal Mental Health Economic impact on women Lack of Awareness/Resources Financial barriers Education of providers Establishing networks Starting the conversation too late!

5 Environmental Influences with direct impact on women s mental health Global National Community Personal

6 Global Impacts Unipolar Depression, predicted to be the second leading cause of global disability burden by 2020, is twice as common in women. World Health Organization, Gender and Women s Mental Health Susan Dowd Stone, LCSW 2012

7 In many developing societies, women bear the brunt of the adversities associated with poverty: less access to school, physical abuse from husbands, forced marriages, sexual trafficking, fewer job opportunities and, in some societies, limitation of their participation in activities outside the home. Patal, V, & Kleinman, A. (2003). Poverty and Common Mental Disorders in Developing Countries.Bulletin of the World Health Organization 2003;81: Susan Dowd Stone, LCSW 2012

8 Apart from the possible role of biological factors, which may explain why there is a consistent sex difference in risks for common mental disorders in all societies, it is plausible that gender factors the considerable stresses faced by women may also play a role. Patal, V, & Kleinman, A. (2003). Poverty and Common Mental Disorders in Developing Countries.Bulletin of the World Health Organization 2003;81: Susan Dowd Stone, LCSW 2012

9 National Impact Economic policies that cause sudden, disruptive and severe changes to income, employment and social capital that cannot be controlled or avoided, significantly increase gender inequality and the rate of common mental disorders World Health Organization, Gender and Women s Mental Health, 2012 Susan Dowd Stone, LCSW 2012

10 Income Disparities Women, when they are able to find work, make only 91% (District of Columbia) to 63% (Wyoming) of what men make for the same position. National Women s Law Center, 2008 Susan Dowd Stone, LCSW 2012

11 Poverty and Women in the United States Record numbers of women were living in poverty and extreme poverty according to an analysis of 2010 Census data by the National Women's Law Center (NWLC). The poverty rate among women climbed to 14.5 percent in 2010 from 13.9 percent in 2009, the highest in 17 years. The extreme poverty rate among women climbed to 6.3 percent in 2010 from 5.9 percent in 2009, the highest rate ever recorded. Over 17 million women lived in poverty in 2010, including more than 7.5 million in extreme poverty, with an income below half of the federal poverty line. Susan Dowd Stone, LCSW 2012

12 Personal Impact Factors E B P E BP BP E B P E Susan Dowd Stone, LCSW 2012

13 Personal Impact Factors Access to mental health services Awareness Partner support Financial difficulties Stigma Ambiguous, confusing messaging

14 Advances in Maternal Mental Health Legislative Research Treatment Awareness

15 Legislative Advances The Melanie Blocker Stokes MOTHERS Act S. 324 Now included in the Patient Protection and Affordable Care Act Watch videos and updates regarding legislation at om/pmadmedialibrary.htm l Susan Dowd Stone, MSW, LCSW, 2011

16 The Good News, the Bad News This work on every level has increased awareness and introduced maternal mental health on a local/national/federal level BUT - Where s the money? Susan Dowd Stone, LCSW 2012

17 Advances in Research From 1800 to articles in Psychinfo describing insanity of pregnancy. For 2012 alone (at press) 48 major peerreviewed studies/articles in established journals.

18 Advances in Research (cont) Current NIMH funding for mental health includes six ongoing clinical trials for postpartum depression ranked in the top ten. R+depressive+disorder+OR+bipolar+depression+OR+postpartum+depression+OR +child+depression+or+adolescent+depression+or+geriatric+depression+or+psy chotic+depression+or+anhedonia+or+dysphoria+or+minor+depression&recr= Open&rslt=&type=&cond=&intr=&outc=&lead=&spons=&id=&state1=&cntry1= &state2=&cntry2=&state3=&cntry3=&locn=&gndr=&fund=0&rcv_s=&rcv_e=&lu p_s=&lup_e=

19 Awareness National, Regional and Local Campaigns Responsible network/cable presentations Print publications Online resources Bloggers Susan Dowd Stone, LCSW 2012

20 The Good News, The Bad News Awareness of the term postpartum depression does not necessarily imply awareness of its symptoms or sources of assistance. Public education is needed to address this fact in order to provide social support and encourage treatment for symptomatic women and their families. Sealy, P. A., Fraser, J., Simpson, J. P., Evans, M., & Hartford, A. (2009). Community awareness of postpartum depression. Journal of Obstetric, Gynecologic, & Neonatal Nursing: Clinical Scholarship for the Care of Women, Childbearing Families, & Newborns, 38(2), Susan Dowd Stone, LCSW 2012

21 PRIMARY PREVENTION

22 Moving the Bar Before pregnancy After delivery

23 Insisting on Evidenced Based Treatment Bio DBT Psycho Psychodynamic CBT, IPT Social IPT Susan Dowd Stone, LCSW 2012

24 Establishing Community Networks Obstetrical Community Resources Pediatric Birth Centers Psychological

25 Social Support Across the perinatal period Concrete Services Encourage self care Asks Questions Peer Support

26 Concrete Services Meal preparation Transportation Childcare Housecleaning Organizing

27 Ask Questions! Gentle approach Give permission to discuss Keep it simple Awareness Psychoeducation

28 Peer Support New Moms Support Groups Telephonic Support Reduction of Isolation

29 Encourage Self-Care SLEEP Recreation Pampering

30 Removing Financial Barriers to Help Postpartum Support International Coordinators and state by state listings of resources Free Chat with the Experts telephone sessions Toll-free warm line

31 Removing Financial Barriers to Help Postpartum Progress most widely read blog on PPD! Huge, reliable resource of information for mothers, healthcare professionals! Katherine Stone, author, survivor, advocate

32 MedEd.PPD Comprehensive online resource focused on research updates and events Available in English and Spanish Portal for providers and consumers Registry of mental health professionals who have had training in PPD MediSpin accorded multiple NIMH grants for their work

33 Mainstreaming Maternal Mental Health into Maternal Healthcare Encouraging national maternal child health organizations to emphasize maternal mental health from contemplation of pregnancy through one year postpartum The National Healthy Mothers, Healthy Babies Coalition Susan Dowd Stone, LCSW 2012

34 National Healthy Mothers, Healthy Babies Coalition Get involved in HMHB programs such as: Text4baby or National Premature Infant Health Coalition and (coming this summer!)

35 National Healthy Mothers, Healthy Babies Coalition Find archived webinars and interviews with experts online at Sign up for the Monday Morning Memo at to get the latest news and resources in maternal and child health. Like HMHB on Facebook and Twitter!

36 Additional Resources /women and depression discoveringhope/what causes depression inwomen.shtml m depression/ds

37 Additional Resources th/behavioralhealth/index.cfm s/treatmentprograms.aspx?id=1271

38 Susan Dowd Stone, MSW, LCSW Co-editor Perinatal and Postpartum Mood Disorders: Perspectives and Treatment Guide for the Healthcare Professional (Springer) Practice: Blue Skye Consulting, LLC, Englewood Cliffs, NJ