Cut PMADs by 20% with Proper Screenings

Experiencing intense anxiety, lethargy, irritability, or sadness can be debilitating when trying to accomplish a simple task. For a task as monumental as caring for a baby, these symptoms of perinatal mood and anxiety disorders (PMADs) affect one in five mothers, many who feel unsupported.

In a recent study, researchers surveyed hundreds of caregivers across the US about their mental health; networks of support; and experiences with caregiving, the health care system, and the workplace. They found that caregivers broadly experienced a lack of support in terms of PMAD screenings and mental health care, access to specialists, a lack of familial support, and inadequate paid leave.

"These findings confirm what families and advocates have been saying for years: our fragmented system is failing parents at one of the most vulnerable times in their lives. Too often, caregivers experiencing PMADs suffer in silence. Our data show that many are never screened by their providers, leaving them to navigate serious mental health challenges on their own," says lead author Erin O'Connor, professor of education and director of NYU Steinhardt's Early Childhood Education Program.

O'Connor and her co-author, Robin Neuhaus, conducted the study through Nested, a nonprofit they co-founded to advance family well-being through research-driven solutions. The report, titled Missed Screenings, Missed Support, draws on data from more than 900 survey respondents and 17 in-depth interviews, and highlights the need for more training for health care providers, increased access to health services and supportive networks, and expanded paid leave.

"I was bouncing between two babies in different parts of the NICU," says Lisa, the wife of an active-duty Navy Special Forces officer and one of the women who provided interviews that supplemented the survey data for a comprehensive picture of ways caregivers are struggling. "My husband only got two weeks of paternity leave, so I was mostly alone."

As she sought therapy to address her heightened anxiety and isolation, Lisa says she felt judged and dismissed.

"The command will say, 'Oh, we support you in all the military spouse appreciation months.' It's just talk…. If you actually appreciated us, you'd staff hospitals and provide child care that works."

Forty percent of caregivers who experienced a PMAD were never screened during a follow-up appointment

Ninety-eight percent of non-birthing caregivers (e.g., fathers, same-sex partners) were never screened for PMADs, despite reporting symptoms

When caregivers were screened, they were often afraid to share mental health concerns for fear of judgment or being separated from their children

Parents of infants in intensive care were 73.5% more likely to experience a PMAD than those whose babies did not require intensive care

Families with more than 12 weeks of paid leave were 80% less likely to leave their jobs

Caregivers in rural and underserved areas reported difficulty connecting with PMAD specialists

The report says that supporting perinatal mental health care requires a coordinated effort to strengthen community resources and advance workplace and health care policy.

More frequent and detailed screening systems to identify symptoms and foster trust

Federally provided paid leave for caregivers and families, and flexible return-to-work programs

Financial credits and assistance for families to address the high costs of child care

Medicaid expansion to include comprehensive perinatal mental health services

Training for health care providers to better identify and treat PMADs

Telehealth services for remote areas