Maternal Mental Health:
An Urgent Priority
30 Opportunities to Improve Maternal Mental Health and Promote Equity
Millions of moms, pregnant women, and other birthing people experience mood disorders, anxiety, depression, post-traumatic stress disorder, or other maternal mental health issues every year. When moms struggle with perinatal depression or anxiety, children are more likely to struggle with social-emotional, cognitive, language, motor, and adaptive behavior development, and these obstacles can persist through adolescence. But it is possible to make real change.
Opportunities for Action
The diversity of factors affecting maternal mental health means that virtually all people and systems that interact with pregnant, postpartum, and parenting people can make a real difference.
We talked with experts in mental health and a range of sectors, who could help inform new and better solutions. They agreed that meaningful progress requires coordinated investments across many sectors, as well as a robust, connected and coordinated mental health advocacy field.
The full report elaborates on each critical theme that emerged, outlined below.
Maximize the impact of health care interventions.
Health systems change needs to happen at both the state and federal levels. That means prioritizing maternal mental health supports, coordinating across systems, and involving diverse providers in the care and well-being of pregnant people and new mothers.
- Integrate non-clinical providers as paid members of care teams.
- Implement cross-system financing or co-led service delivery pilots.
- Develop a coordinated federal strategy that cuts across silos.
- Develop a reform roadmap for states.
- Increase access to postpartum depression screening and treatment.
- Establish public-private maternal mental health commissions charged with improving outcomes and equity.
- Develop commission-led state policy roadmaps aligned with the above federal roadmap.
- Implement “no wrong door” to maternal mental health care and human services.
- Leverage Temporary Assistance to Needy Families (TANF) to mitigate family financial stress factors.
- Help doctors identify maternal mental health needs and make effective referrals.
- Address language barriers within health systems.
Broaden the response to address the full range of well-being obstacles.
Maternal mental health issues do not occur in isolation. It’s imperative to address social determinants of maternal mental health and facilitate access to treatment and prevention services. Collaboration between agencies and policy change are necessary to achieve these goals that are rooted in health equity.
- Identify case studies describing hospital system or health plan interventions that addressed social determinants of health, resulting in family well-being and mental health improvements.
- Facilitate “warm” referrals by health care providers to effective prevention services and interventions that address social determinants.
- Require collaboration between health agencies and aligned agencies (such as child welfare agencies) to approach maternal substance use from a public health perspective.
- Advance comprehensive policy reform agendas that address a wide range of issues impacting families’ mental health and health equity.
Build new community-centered maternal mental health support systems.
The people in the best position to define what supports birthing people need are those in the communities we serve. Community organizations need increased capacity, resourcing, and power to take a leadership role in efforts to identify the gaps and advance creative solutions.
- Convene collaborations led by community-based organizations that bring representatives of relevant systems (home visiting, domestic violence, health plans, TANF, etc.) together to recommend integrated supports for families.
- Cultivate community-based organizations’ power-building, so they can partner as equals with institutional health care sector leaders like health plans or insurers.
- Conduct community assessments and use findings to close care gaps.
- Cultivate public-private financing partnerships for pilot projects.
Center women of color and other historically-marginalized people.
Women of color and those with lower incomes are at an increased risk of experiencing maternal mental health issues. The health care system must adapt to serve the needs of these communities with culturally relevant, anti-racist care models informed by people they are meant to serve.
- Ensure that reform strategies are informed by anti-racist best practices, that these strategies reflect the experience of women of color, and that women of color have a substantive role in the development of financing models and policy reforms.
- Build more culturally-relevant, comprehensive, and accurate measurements.
- Commission a national survey of relevant programs.
- Advocates should push for increased Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA) funding for community-based maternal mental health supports.
Expand advocacy to influence and accelerate policy change.
Maternal mental health is a complex issue; those in a position to make change often don’t have a full understanding of it. Advocates and stakeholders are key to lifting up the nuances of what maternal mental health is, whom it most affects, and how to advance equitable change.
- Ensure that maternal mental health advocates and stakeholders have a seat and voice at key advocacy coalition tables.
- Convene an advocacy network focused on federal maternal mental health funding.
- Complete a scan of media coverage.
- Implement a narrative change effort.
- Make a communication plan.
- Develop stories of action, system change, and health.
- Make better use of social media
A Step Toward Action
Informed and inspired by the strategy sessions and the recognition that opportunities for action require resources, a collaborative of philanthropic funders who prioritize maternal mental health, including Perigee Fund, launched Funders for Maternal Mental Health at the end of 2021. Investing in maternal mental health results in better outcomes for many philanthropic priorities across a number of systems, leading to stronger families and communities.