City hospitals take aim at maternal depression

Bellevue commits to universal screenings

Chirlane McCray speaks at Bellevue Hospital. (Photo by Maria Rocha-Buschel)

Chirlane McCray speaks at Bellevue Hospital. (Photo by Maria Rocha-Buschel)

By Maria Rocha-Buschel

New York City First Lady Chirlane McCray recently announced that the city is setting a goal to provide universal screening and treatment for maternal depression for all pregnant women and new mothers.

McCray made the announcement at Bellevue Hospital on November 17 along with representatives from NYC Health and Hospitals (formerly HHC), Maimonides Medical Center and the Greater New York Hospital Association.

NYC Health and Hospitals and Maimonides, which together perform about 25 percent of all deliveries in New York, have committed to achieve universal screening and connection to treatment within two years as the first step towards the goal. The Greater New York Hospital Association will also begin developing a learning network of hospitals across the city to screen all pregnant women and new mothers for the condition within that two-year period.

“As all of the moms in this room know, giving birth is also one of life’s most challenging experiences and I’m not just talking about labor,” McCray said. “During pregnancy and childbirth, a woman’s body undergoes a tremendous amount of change. Studies suggest that at least one in every ten pregnant women and new mothers suffer from (postpartum depression). That’s the bad news. The good news is that postpartum depression is treatable.”

Paige Bellenbaum, a mother who has shared her story about her diagnosis and treatment on the Today Show and NPR, said that postpartum depression blindsided her following almost 20 hours of labor.

“I couldn’t wait for that magical moment to meet my son but the reality couldn’t have been further from the truth,” she said. “Nobody told me about baby blues and postpartum depression. The hospital gave us samples of Similac (formula) and sent us on our way.”

Bellenbaum noted that even as a social worker trained to recognize mental illness, she didn’t identify the signs of the condition in herself and advocated for universal screening to prevent what happened to her from happening to other new mothers.

“I felt trapped and didn’t feel emotionally connected to my son at all,” she said. “I watched other moms bonding with their babies and couldn’t tell anyone what I was feeling because I was ashamed.”

NYC Health and Hospitals President Dr. Ram Raju agreed that the stigma of postpartum depression prevents many women from seeking treatment and universal screening will help normalize the diagnosis.

“We don’t need any fancy equipment to start doing this,” he said. “It’s just connecting with the patients. It’s so simple that it should be part of routine care. Through education we can overcome the stigma.”

Raju said that the healthcare delivery system is changing and NYC Health and Hospitals has started integrating primary care and mental health care, and this initiative is in line with those efforts.

“It’s a shift in the way that we look at patients,” he said.

McCray agreed that making the services more easily accessible will help new mothers get the help they need without worrying what others think of their parenting abilities.

“No woman wants to be a bad mother,” said McCray. “But depression, coupled with the stigma and fear of being labeled a bad mom, can keep women from reaching out for the help they need.  That is why universal screening is essential.”

New York State Medicaid started reimbursing physicians for screening pregnant women for maternal depression this past October. Symptoms of maternal depression, which includes depression during pregnancy as well as postpartum, can range from mild to severe and may include feeling hopeless, sad or overwhelmed, as well as crying a lot, having trouble focusing or having no energy or motivation.

McCray’s announcement was related to a new city health campaign with a $850 million budget over the next four years and includes 54 initiatives. In addition to closing the treatment gap in maternal depression, other programs include a public awareness campaign, mental health service finder, mental health services for CUNY students and others.

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