Discussion on Perinatal Mental Health

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Week 1 – Pediatric and Perinatal Mental Health Discussion
Class and Dr.,
Discuss at least two beliefs or other factors that are related to pediatric or perinatal mental healthcare that create barriers to mental health treatment.
As mothers and nurses, we hear this phrase, “Breast is best.” It turns out that “breast is best” has created a barrier to perinatal mental healthcare. In her interview with Maternal Mental Health Leadership Alliance, Dr. Raja explains that “breast is best” may not be best for everyone (Hinson, 2022). Breastfeeding is very time-consuming for a mother and disrupts sleep hygiene. When a mother’s expectations about breastfeeding do not match their reality, it can harm their mental health, leading to feelings of anxiety, depression, and guilt. Women with serious mental illnesses must prioritize their mental health to provide proper care to their new babies. This includes getting enough sleep and making sure they take their medications. Research has shown several psychiatric drugs to be safe during pregnancy and lactation, but many still have unknown side effects. It is essential to have a plan in place early on so the mother feels supported in her decision to take care of herself in a way that allows her to provide the best care for her baby, whether this includes breastfeeding or not.
Black women are underrepresented among clients receiving mental health treatment and education. The lack of universal screening and mental health education for Black mothers and birthing people is another barrier to mental health treatment. This lack of universal screening and mental health education for Black mothers can lead to cross-generational trauma, mom-shaming and blaming, and feelings of hopelessness and worthlessness. When new Black mothers are not screened or educated that depression can be treated, it can impact the mother-baby bond and their ability to be the matriarch their family expects them to be.
Identify at least two specific education strategies or resources the PMHNP can provide to clients and families to address these barriers.
Treating for two: Medicine and Pregnancy is a website developed by the Centers for Disease Control and Prevention that provides resources for providers and mothers about medications during pregnancy (CDC, 2022). Drugs and Lactation Database (LactMed), developed by the National Library of Medicine, is a website for providers that has a database of drugs and other chemicals that breastfeeding mothers may consume or be exposed to, the levels of such substances in breast milk, and the potential for adverse effects in the nursing infant (Drugs and Lactation Database (LactMed®), 2023). LactMed also provides therapeutic alternatives if available.
20/20 Mom is an organization with a mission “to close gaps in maternal mental health care” (Mom, 2020). This site offers mental health screening tools for providers, education posters, advocacy opportunities, and more. Supporting Black Women’s Maternal Mental Health Journey is an American Hospital Association article that outlines ways hospitals can improve Black women’s maternal health through listening, education, screening, and partnering with Black Maternal Health Organizations (Diener, 2022).
Identify one policy at either the federal, state or local level that impacts mental health services for children and adolescents or clients in the perinatal period. Explain whether the policy supports or inhibits services.
Bringing Postpartum Depression Out of the Shadows Act of 2015 is a federal bill that amends the Public Health Service Act to make grants to states for programs that support screening perinatal women for depression (R.3235 - 114th Congress (2015-2016): Bringing Postpartum Depression out of the Shadows Act of 2015, 2015). This bill provided grants to seven states to promote provider education on maternal mental health. Although small, this is one of the first policies that support maternal mental health.
Describe at least two advocacy strategies the PMHNP can use to advance mental health services for children and adolescents or clients in the perinatal period. Identify other professionals the PMHNP can collaborate with to bring about change.
PMHNPs can support programs like 20/20 Mom and their two federal policy platforms being considered by legislation, Black Maternal Health Momnibus and the TRIUMPH for New Moms Act (Griffen, 2021; Policy, 2020). The Perinatal Mental Health Advocacy Toolkit is an online book that can be used as an educational tool to promote perinatal mental health through education, organizations, speaking up at town hall meetings or social media, or training (Toolkit, 2021).
PMHNPs can collaborate with individuals with lived psychiatric mental health (PMH) experiences, family and friends impacted by PMH, medical professionals who work with perinatal people, mental health providers, nonprofit organizations, and legislators (Toolkit, 2021).
Thank you,
References
CDC. (2022). Treating for Two: Medicine and Pregnancy. Centers for Disease Control and Prevention. https://www(dot)cdc(dot)gov/pregnancy/meds/treatingfortwo/index.html
Diener, M. (2022). Supporting Black Women’s Maternal Mental Health Journey | AHA News. American Hospital Association | AHA News. https://www(dot)aha(dot)org/news/blog/2022-07-19-supporting-black-womens-maternal-mental-health-journey
Drugs and Lactation Database (LactMed®). (2023). Nih.gov; National Institute of Child Health and Human Development. https://www(dot)ncbi(dot)nlm(dot)nih(dot)gov/books/NBK501922/
Estriplet, T., Morgan, I., Davis, K., Crear Perry, J., & Matthews, K. (2022). Black Perinatal Mental Health: Prioritizing Maternal Mental Health to Optimize Infant Health and Wellness. Frontiers in Psychiatry, 13. https://doi(dot)org/10.3389/fpsyt.2022.807235
Griffen, A. (2021). Mental Health Conditions: U.S. Policies and Practice to Address the Most Common Complication of Pregnancy and Childbirth. New Security Beat. https://www(dot)newsecuritybeat(dot)org/2021/10/mental-health-conditions-u-s-policies-practice-address-common-complication-pregnancy-childbirth/
H.R.3235 - 114th Congress (2015-2016): Bringing Postpartum Depression Out of the Shadows Act of 2015. (2015). Congress.gov. https://www(dot)congress(dot)gov/bill/114th-congress/house-bill/3235
Hinson, M. (2022, August 15). Breast Is Best. Really? Always? Maybe not... - MMHLA. MMHLA. https://www(dot)mmhla(dot)org/breast-is-always-best/#
Mom. (2020). 2020 Mom. 2020 Mom. https://www(dot)2020mom(dot)org/our-work
Policy, F. (2020). 2020 Mom. 2020 Mom. https://www(dot)2020mom(dot)org/federal-policy
Toolkit, A. (2021). PERINATAL MENTAL HEALTH. Maternal Mental Health Leadership Alliance. https://www(dot)mmhla(dot)org/wp-content/uploads/2021/03/MMHLA-Advocacy-Toolkit-February-2021.pdf