A significant number of women experience mental health and substance use symptoms during pregnancy or the postpartum period, yet only a small percentage receive adequate mental health care. Effective treatment of perinatal depression and / or substance use is perhaps the single most effective strategy to support perinatal people and their families and to prevent future mental health and substance use problems in children, adolescents and adults.

The Medicaid and Mental Health Project, led by the PERC Center, aims to improve access to evidence-based mental health care for pregnant and postpartum women in Washington State, with a particular focus on individuals insured by Medicaid. Almost half of all the births in Washington State are covered by Medicaid, jumping to 66% of births to Black women. In Washington, residents with an income at or below 193% of the federal poverty level can receive one-year of postpartum Medicaid coverage. This gives us an enormous opportunity to ensure that every woman with perinatal mental health problems receives the support and care they need.

“For far too long, we as an obstetric caregiver community, have not provided the support and resources needed to address perinatal mental health challenges and their impacts on pregnancy, birth and the postpartum period,” says Judy Lazarus, DNP, CNM, ARNP, FACNM, who works at one of the clinics participating in the project. “We have too few resources to address this key element in providing perinatal care and that needs to change. This project is critical to gaining a better understanding of the issues and how we can provide better care.”

In the first year, the project team developed best practices for mental health screening, follow up, tracking, and treatment completion for Medicaid-insured women receiving prenatal or postpartum care in collaboration with our working group comprised of clinical, Medicaid managed care, and policy stakeholders. In the second year, the team will work to develop workflows for clinics to identify and reach every pregnant or postpartum individual with mental health needs to provide appropriate care and support. The team will provide clinics with psychiatric consultation as well as perinatal mental health and substance use technical assistance and training.

The Medicaid and Mental Health Project, funded by an anonymous donor, is led by Amritha Bhat, MD, MBBS, MPH, and Deb Cowley, MD, and staffed by Jamie Adachi, MPH.