Michigan, USA – Perinatal mood and anxiety disorders (PMAD), formerly known as postpartum depression, affect over 23,000 Michigan women and their families annually. This equates to nearly 20% of mothers and 10% of fathers of infants, with countless additional cases going unreported or undiagnosed. However, a series of innovative initiatives in Michigan are striving to revolutionize the screening, diagnosis, and treatment of PMAD, offering hope to those affected.
While PMAD primarily affects biological mothers, it can also impact adoptive mothers, fathers, partners, caregivers, and other children within the family. Moreover, PMAD is considered an adverse childhood event that can lead to attachment disorders, hindering children’s prospects for academic success, meaningful relationships, and emotional well-being throughout their lives.
Dr. Andrea Wittenborn, director of the Michigan State University Couple and Family Therapy doctoral program, emphasizes the importance of recognizing the wider context in which postpartum depression operates. She notes that while the effects are primarily felt by the mother, partners, newborns, other children in the household, and significant individuals in their lives are also affected. Partners may experience challenging symptoms that mirror those of the mother, such as feelings of helplessness, increased stress, and emotional distress in witnessing their partner’s struggle.
PMAD manifests in various symptoms, including depression, anxiety, guilt, irritability, anger, sleep disturbances, poor appetite, feelings of overwhelm, disconnection from the baby, and distressing intrusive thoughts. Contrary to common misconceptions, PMAD can emerge during pregnancy and up to two years after childbirth.
Dr. Wittenborn’s project, “Implementing and Sustaining Integrated Care for Perinatal Depression,” offers training and technical support for the screening and treatment of perinatal depression in six health centers. These include McLaren Health Care in Flint, Genesys Regional Medical Center in Grand Blanc, Corewell Health in Grand Rapids, and three Sparrow Health System clinics in Lansing, all funded by the Michigan Health Endowment Fund.
The project employs the collaborative care model, a proven evidence-based approach used in over 80 randomized controlled trials. It involves physicians, behavioral health specialists, and consulting psychiatrists working together to care for patients with perinatal depression, marking a significant shift in the way healthcare is delivered.
Prior to implementing the collaborative care model at these sites, only 16% of at-risk women were connected with behavioral health care workers. Following implementation, this figure increased to 71%, signifying a remarkable improvement in access to care.
In Calhoun County, the Battle Creek Community Foundation collaborates with the Calhoun County’s Population Health Alliance to offer “Frontline Provider PMAD Training.” This initiative aims to provide underserved pregnant and postpartum parents in Calhoun County with greater access to specialized mental health care screening. The training educates non-behavioral health medical staff and other non-medical professionals in recognizing signs and symptoms of perinatal mood and anxiety disorders.
The goal is to standardize this new information as part of routine care, empowering providers and non-providers who work with families to reduce the stigma surrounding these conditions.
These programs are just a glimpse of the positive strides being taken to enhance support for PMAD in Michigan and across the nation. In Lenawee County, the University of Michigan School of Social Work’s “Implementing Depression Treatment for Mothers in Head Start” initiative collaborates with Adrian Public Schools Head Start Early Childhood Programs to identify unmet mental health needs among families.
Wayne State University’s “High Touch High Tech” initiative utilizes iPads and a Pregnancy Checkup app to screen pregnant individuals for mental health and substance use-related risks in prenatal clinics while providing tailored information and links to additional content via text messages. This approach has notably increased behavioral health service utilization.
On a national level, the FDA recently approved the first oral medication for postpartum depression.
The combined efforts of screening, therapy, medication, and a supportive healthcare team are helping individuals affected by PMAD embark on the path to recovery while addressing the stigma that often deters new parents from seeking help.
In conclusion, the state of Michigan is witnessing a significant shift in how it approaches and addresses perinatal mood and anxiety disorders, providing renewed hope for thousands of families affected by these conditions.
