Improving Maternal Mental Health Care

1 in 5 California Moms Suffers from Pregnancy-Related Depression

Why This Work Matters

One in five California women suffers from depression, anxiety, or both while pregnant or after giving birth, negatively impacting the mother and the child. Despite this high prevalence of mental health issues, few women receive treatment. CHCF is working with partners to better understand this issue and to explore innovative, practical solutions for delivering mental health care to California’s mothers and expectant mothers in need.

Perinatal mood and anxiety disorders are the most common medical complication affecting women during pregnancy and after childbirth. They include prenatal and postpartum depression and/or anxiety, and, in extreme cases, postpartum psychosis. According to the Maternal and Infant Health Assessment (MIHA) conducted by the California Department of Public Health (CDPH), 21% of pregnant and postpartum women in California are affected. The prevalence is estimated to be even higher in some populations. For example, one in four African American and Latina mothers in the state reports depressive symptoms, and so do as many as half of all mothers living in poverty.

Left undetected and untreated, these conditions can lead to negative health outcomes for the mother, and can negatively affect the mother-child bond and the child’s long-term physical, emotional, and developmental health. Additionally, the financial cost of untreated maternal mental health conditions can be significant (for example, more use of emergency care services, higher rates of absenteeism at work).

Our Approach

Fortunately, these conditions are treatable, and early detection can make a significant, positive impact. CHCF is currently funding projects to better understand maternal mental health care in California and to explore ways that it can be improved. A summary of the projects that are part of CHCF’s current maternal mental health portfolio is provided below.

Project Highlights

Transparency/Monitoring/Data

Delivery System Interventions

  • A pilot program run by the Los Angeles County Health Agency and the University of Southern California is testing the use of secure emails in electronic consultations between reproductive psychiatrists and general psychiatrists to improve management of pregnant and postpartum women with severe and persistent mental illness. (In process)
  • Researchers from the University of Washington and the Advancing Integrated Mental Health Solutions Center, in collaboration with the Oregon Community Health Information Network and the University of Pennsylvania, are assessing the impact and cost-effectiveness of provider-to-provider longitudinal remote consultation for the management of perinatal depression in community health centers and other primary care practices. The National Institute of Mental Health is the main funder. CHCF is supporting four (of the approximately 20 participating) sites based in California: ChapCare, Central Neighborhood Health Foundation, Alliance Medical Center, and Open Door Community Health Centers. (In process)
  • The Institute for Medicaid Innovation identified promising approaches to address maternal depression and anxiety during pregnancy and one year post birth, with a focus on the Medicaid population. (October 2018)
  • Maternal Mental Health Now tested collaborative maternal mental health care in three Los Angeles community clinics: Harbor Community Clinic, Eisner Pediatric and Family Medical Center, and Martin Luther King, Jr. Outpatient Center. (February 2018)

Payment

  • Along with ZOMA Foundation and the Perigee Fund, CHCF funded Mathematica to estimate the total societal cost of perinatal mood and anxiety disorders. A report sharing the national numbers as well as the findings for California, Colorado, and Washington State was produced. (April 2019)

Policy

  • CHCF and The California Endowment supported the nonprofit 2020 Mom in spearheading a statewide task force on maternal mental health in California, which produced a report with recommendations. 2020 Mom is now working to implement the recommendations with stakeholders. (April 2017)

Consumer Engagement

  • CHCF is funding Hollywood, Health & Society, a program of the USC Annenberg Norman Lear Center, to provide materials that help screenwriters more accurately depict maternity care on television and in other entertainment programming. (In process)

Learn More

For more information, contact CHCF’s Stephanie Teleki.