The following articles caught my eye in the first part of February, most notably, we are close to having a pill form of brexanolone (Zulresso), called zuranolone. Zulresso was the first drug on the market developed specifically for maternal depression, which exists only in an intravenous form. We’re also highlighting an article from Health Affairs that describes an increase in PCP visits for mental health concerns, something we surely are seeing in obstetrics too. Finally, the tragedy in Massachusetts involving a suspected case of postpartum psychosis (likely triggered not only by lack of sleep, but the 10+ drugs this mother was prescribed) has inspired a lawmaker to introduce a bill to put such mothers in intensive treatment programs rather than in jail.

In January news broke about a Massachusetts mother, Lindsay Clancy, reportedly suffering from postpartum psychosis, taking her 3 children’s lives and attempting to take her own. We picked the article that best describes the situation and the nuances of postpartum psychosis in this edition of What We’re Reading.

Many important articles were released these first two weeks of the new year including a study highlighting the wealthiest of Black women still have higher maternal death rates than the poorest of White women. And a new research study confirms that paid leave is critical in supporting mothers with maternal mental health disorders and that generous paid leave can prevent maternal depression.

In this edition, we share the latest articles on maternal health, telehealth, and reproductive access (including new labeling of the morning after pill).  The articles that most excited and saddened me were an article addressing the role a bachelor’s level psychologist can play in conducting assessments to pinpoint diagnoses, and a new study that highlighted the pandemic had an outsized impact on maternal overdoses – an 81% increase from 2017-2021.

At the 2023 Maternal Mental Health FORUM we will dive into the relationship of infant mental health and maternal mental health. This issue of What We Are Reading several articles and studies highlight this important relationship and address the impact of untreated maternal mental health disorders on children. It’s my hope that infant mental health specialists will soon specialize in maternal mental health. Read more about this and other important issues below.

The articles that have recently caught my eye are highlighted below and include the White House’s effort to promote food as intervention, bright light therapy as a treatment for PPD, and how we must consider and support proliferation of birth centers in hospital maternity desserts. The last article points out the rise of Black infant death (and likely preterm birth) during the pandemic - a likely correlation between increased maternal distress.

This edition of What We’re Reading covers the role of obstetricians as the primary medical home during the perinatal period and addresses the role OBs can begin to play on children's brains noting “Obstetrics is primed for the shift that is happening in pediatrics, which is moving from its traditional focus on physical health to a coordinated, whole-child, 2- or multigeneration approach.”

In this issue, articles covering solutions for addressing long-standing health inequities are proposed, two new treatments are discussed and as well as cost as a significant barrier to health in the U.S. both perinatal women and men generally. Also in this issue are conflicting findings about whether patients are finding more in-network behavioral health providers. My take (and personal experience) is that they are, through virtual behavioral health companies that are contracting with insurers, like Happier Living and other virtual provider network companies.

In this edition of what we are reading, I highlight a study on the top reasons young adults don’t access behavioral health care; the number one reason won’t surprise you, it’s cost. Another article is reason for hope, a synopsis on how states and Congress are responding to increasing stresses and maternal mental health. I also highlight a study in this edition that helps us understand why women often have sudden onset of suicidal ideation in the postpartum period and explains what clinicians can do about it.

The articles in this edition are organized by topic so you can quickly skim this post to find the news most interesting to you. A theme has bubbled up with a set of three articles in this edition, are titled:

“Is It the Right Time for a Paradigm Shift in Mental Health Care Delivery?”
“Opinion: Maternal Mental Health Should Be a Priority for ALL”
and
“Our Clinics Meet Mental Health Needs and Lighten the Load on Police. Let’s Go Nationwide”

The authors of these articles argue that now is the time to increase the capacity of community-based mental organizations and facilities. This included a discussion held at the American Psychiatric Association conference. Read more in the “Community Based Mental Health” section.

So far this month, the following articles caught my attention. You’ll now see articles grouped by topic, including Suicide, Interrelated Issues, Treatments, Race, Abortion, and more. More studies than usual were printed so far this month relative to treatments. Give this run-down a skim. You can also find these articles posted on our social media platforms throughout the month. Join us there to discuss these findings.

This edition of my twice-monthly article round-up includes a commentary about the need to more urgently address shortages of psychiatrists. I couldn't agree more, and I also think we must increase the number of psychologists, those who can do full assessments of mothers (and others) with complex symptoms and causes, so we can accurately diagnose and treat the right problem, which may or may not need an RX or MD prescribed treatment. We also need to start thinking about mental health ‘medical homes’ which provide psychological assessment, therapy, peer support, psychiatric support, and care coordination with the PCP or in our case, Ob/midwife.