What You Need to Know About The National Strategy to Improve Maternal Mental Health
By: Adrienne Griffen, MPP, Executive Director, Maternal Mental Health Leadership Alliance
On May 14, 2024, The Department of Health and Human Services released two bodies of work created by the Task Force on Maternal Mental Health: the official Report to Congress and National Strategy to Improve Maternal Mental Health Care. Together, these two documents provide a snapshot of current maternal mental health care systems, policies, and practices in the United States, and they offer a comprehensive strategy to prioritize the mental health and wellbeing of our nation’s mothers and childbearing people.
In this article, I share highlights of both the Report to Congress and the National Strategy, and I offer some suggestions about what we all can do — individually and collectively — to ensure the Task Force’s recommendations are implemented.
A Task Force of over 100 experts produced the Report to Congress and the National Strategy.
The Report to Congress and National Strategy were produced by the Task Force on Maternal Mental Health, which was established by Congress through the TRIUMPH for New Moms Act — legislation led by The Policy Center for Maternal Mental Health.
The Task Force included over 100 individuals — including federal government officials, experts in mental health and health care, advocates, and individuals with lived experience — who worked together for almost 6 months to produce the Report to Congress and the National Strategy.
As the Executive Director of the Maternal Mental Health Leadership Alliance, I was honored to be invited to join the Task Force, and I am proud of the incredible amount of work that was accomplished in a very short period of time. The Task Force is the most robust, comprehensive, and inclusive action taken by the federal government to address maternal mental health that I have seen in my two decades of working in this field.
“The Task Force on Maternal Mental Health is the most robust, comprehensive, and inclusive action taken by the federal government to address maternal mental health that I have seen in my two decades of working in this field.”
— Adrienne Griffen, MPP, Executive Director, Maternal Mental Health Leadership Alliance
The United States is facing a maternal mental health crisis.
In the United States, more women die during pregnancy and the year following pregnancy than in any other developed country. Tragically, mental health conditions are the leading cause of maternal mortality, accounting for almost 23% of maternal deaths.* I often ask myself, “How is it possible — in a country that spends more per capita on healthcare than any other country — that so many mothers die?”
The vast majority of those impacted by maternal mental health conditions — as many as 75% — do not receive treatment, increasing the risk of long-term negative impacts on mothers, babies, and families. In addition, the cost of not treating maternal mental health conditions is $32,000 per mother-infant pair, or $14 billion each year in the United States.
These jarring statistics along with increased societal awareness of these issues, recognition of disparities, years of advocacy efforts, and political momentum from the White House Blueprint for Addressing the Maternal Health Crisis all culminated as a catalyst that led to the establishment of the Task Force and the resulting Report to Congress and National Strategy.
*Note: The leading causes of death for Black women are cardiac and coronary conditions.
“Tragically, mental health conditions are the leading cause of maternal mortality, accounting for almost 23% of maternal deaths. How is it possible — in a country that spends more per capita on healthcare than any other country — that so many mothers die?”
— Adrienne Griffen, MPP, Executive Director, Maternal Mental Health Leadership Alliance
The National Strategy, if implemented, will elevate the mental health and wellbeing of our nation’s mothers and childbearing people.
It is important that we know what is included in the National Strategy. I encourage anyone working in the field of maternal mental health — researchers, administrators, policymakers, health care providers, mental health experts, and advocates — to become familiar with the National Strategy so that collectively we can drive policy and systems change within our communities, our places of work, and our local, state, and federal governments.
The National Strategy envisions a system of care for maternal mental health conditions that is seamless and integrated across medical, community, and social systems and that is built upon the following five pillars.
Pillar #1: Build a national infrastructure that prioritizes perinatal mental health and well-being.
Report Findings: Our nation currently lacks the infrastructure and environment to best support optimal maternal mental health and wellbeing. There is a lack of federal legislation and policy to support parental leave or childcare; activities at the federal level require better coordination; systems of care are often fragmented and do not meet the needs of the mother-infant dyad; and some policies are stigmatizing and punitive, especially around maternal substance use disorders.
National Strategy Recommendations: 1) Establish federal laws for parental leave and childcare; 2) address stigma and improve disparities; 3) integrate physical and mental health care; and 4) implement universal education, prevention, screening, treatment, and support for maternal mental health conditions and substance use disorders during and following pregnancy.
Pillar #2: Make care and services accessible, affordable, and equitable.
Report Findings: Individuals experiencing maternal mental health conditions and substance use disorders face many barriers in accessing care that is equitable and affordable: workforce shortages, fragmented systems of care, providers struggling to receive reimbursement and payment, and care that is not always linguistically or culturally relevant.
National Strategy Recommendations: Address issues of diagnosis, reimbursement, access, continuity of care, and workforce shortages.
Pillar #3: Use data and research to improve outcomes and accountability.
Report Findings: Our nation currently faces many challenges related to maternal health data overall, including data related to maternal mental health conditions and substance use disorders.
National Strategy Recommendations: Enhance the quality of data collection, interpretation, measurement, analysis, and dissemination, including ensuring that maternal mortality review committees and perinatal quality collaboratives are in place nationwide.
Pillar #4: Promote prevention and engage, educate, and partner with communities.
Report Findings: The federal government’s work will be most successful if carried out in collaboration with states, public-private entities, industries, advocates, medical and professional societies, communities, and individuals with lived experience and their families.
National Strategy Recommendations: Identify opportunities to bring partners together to promote and fund community-based prevention strategies that focus on empowerment and resilience, and to provide education about maternal mental health and substance use disorders.
Pillar #5: Lift up lived experience.
Report Findings: The United States Digital Service conducted a 6-week research sprint in January 2024 to capture information on the lived experiences of individuals who have suffered from maternal mental health conditions and the providers who work with them. The findings of this research deepened and validated the insights and recommendations of the Task Force.
National Strategy Recommendations: The voices of those with lived experience must be sought out, uplifted, and incorporated into this important work.
This is a terrific strategy and vision. How do we make it a reality?
The recommendations of the Task Force are incredibly comprehensive and offer hope that we can combat the maternal mental health crisis in our country. However, implementing these recommendations will require change at all levels and across all sectors, including government, medical, community, and social systems.
How do we, both collectively and individually, ensure these recommendations move from words to action?
Suggestion #1: We must all think of ourselves as policymakers, innovators, and agents of change.
While the Task Force calls for a “whole of government” approach to addressing maternal mental health, many recommendations will require change across other sectors. For example, educating and screening all pregnant and postpartum people for maternal mental health conditions will entail innovation and change by national medical and professional societies, insurance companies, healthcare systems, medical practices, and even individual providers. We must all embrace our role as changemakers, whether we are establishing screening and treatment protocols, ensuring providers are adequately and easily reimbursed, or creating community-based programs to address racial, social, and cultural disparities.
Suggestion #2: Collective advocacy is critical. We must hold our nation’s leaders accountable in transforming the National Strategy from words on a page to real and lasting policy change.
I cannot stress enough the importance of getting involved in collective advocacy. We must advocate for policies that will push the National Strategy recommendations forward. We must hold policymakers and government officials accountable at all levels — federal, state, and local — in implementing policies and providing funding to better support parents and families. We must ensure that the recommendations do not die on the page.
The Reverend Starsky Wilson summarizes the importance of policy change: “Policies are covenants we collectively choose to live by, as articulated in legislation and regulation. They inform our socially accepted morals and ethics.”
This is why we at Maternal Mental Health Leadership Alliance organize an annual Maternal Mental Health Advocacy Day, bringing together everyone who cares about maternal mental health to meet with Congressional representatives and advocate for policy change. Our collective advocacy has led to establishing national-level maternal mental health programs (including the National Maternal Mental Health Hotline and the Screening and Treatment of Maternal Mental Health and Substance Use Disorder Program) and garnering $68.5 million in federal funding to support them.
Suggestion #3: Be engaged. Help new parents. Make change in the community.
Maternal mental health impacts our families, friends, colleagues, and communities. We all have a mother; we all start life as an infant; we all have family. Thus, we all have a responsibility to ensure that mothers, childbearing people, infants, and families get off to the best start possible.
Help new parents. Bring a meal, fold the laundry, or hold the baby so parents can have a break. Ask pregnant and postpartum parents how they are doing; reassure them that maternal mental health conditions are common, temporary, and treatable. Tell them about the National Maternal Mental Health Hotline (1-833-TLC-MAMA) and let them know that help is just a text or phone call away.
Make change in the community. Help erase stigma about maternal mental health by uplifting stories of lived experience. Share information about the National Maternal Mental Health Hotline on social media and with maternal-child healthcare providers and mental health professionals. Implement education and screening for mental health conditions in practices and programs. Start a support group for new parents. Join a state chapter of Postpartum Support International.
Final thoughts…
Our government is addressing the maternal mental health crisis in an unprecedented way, but we cannot expect that government action alone will be enough. Real change will require that we all become involved. This is our opportunity to leverage this momentum and look to the National Strategy to help us build the country that we all deserve.
