The Mamafesto: Moms need mental health checks, and they need them now
Mental health continues to exist in its own stigma-trimmed bubble in the overall world of health. It's not talked about the same way other illnesses like cancer or diabetes are, and yet it impacts more people than lung disease, heart disease and cancer combined. Thanks to New York City's first lady, Chirlane McCray, that silence is starting to crack as she pushes for citywide policies and reform to help those affected by mental health issues.
According to the CDC, 8 to 19 percent of women have reported experiencing some form of postpartum depression. The problem with this statistic is that the experiences are self-reported, leaving out the many women who may be suffering in silence, who may not be aware they're experiencing PPD or who are too ashamed or afraid to talk about it. The real number of women who suffer from some sort of postpartum mental health challenge is probably much higher.
Postpartum depression, psychosis and anxiety do not discriminate. They can impact women of any age, race, income bracket or sexuality. And with the continued stigma that surrounds mental health issues in general combined with the pressure of the "Good Mother Myth," many women may shy away from seeking help, which can impact their own health and safety and that of their family. So what is being done to help women and families impacted by PPD?
Perhaps we need to look to NYC to see the revolutionary actions it's taking and use it as a blueprint for cities across the country.
I recently had the privilege of being part of a conversation with McCray as she discussed her ThriveNYC campaign and maternal mental health in particular. McCray talked about the need to change the way people think and talk about mental health in order to help those who need it most.
"Fear is really the greatest factor" in not wanting to talk about mental health, said McCray. "Why are people afraid? Because they don't understand, because they think there are no solutions. But that's not true anymore."
McCray noted that talking about mental health issues helps in destigmatizing it all. She referenced celebrities in particular as folks who have stepped up to be open about their mental health challenges. It certainly can make some people feel less alone when they hear their favorite actor or actress talk about their own mental health issues.
In addition to mental health in general, an important part of ThriveNYC is maternal health care. According to McCray, the city of New York is committed to screening all new mothers for postpartum depression. ThriveNYC's website makes this commitment clear:
NYC has set a goal to screen and, when needed, connect all pregnant women and new mothers to treatment for pregnancy-related depression. Almost one-quarter of all births in New York City take place at the NYC Health and Hospitals Corporation or Maimonides Medical Center. As a first step to meet our goal, they have committed to begin universal screening and treatment for their patients within two years.
For McCray, that means outfitting not just OB-GYNs and midwives with the skills to detect PPD in new moms. Pediatricians should also have the ability to screen and help women with PPD, as sometimes they are the first medical professionals a new parent might see after a baby is born. The problem is that many doctors aren't trained to specifically look for signs and symptoms of PPD. Ideally, better training will occur all over, not just in NYC, to be able to reach more mothers.
Further adding to the impact of what she was saying, McCray shared her postpartum time after having daughter Chiara. She explained that six weeks of maternity leave wasn't enough, and she pushed for eight so she could be physically ready to go back to work. "I don't know if my mind was ready," she joked, but there's a huge layer of truth to it. "We had no family around us to give us that extra support that women often need. And so many women have similar circumstances. So many. And you think about immigrant women and single mothers, and it's even more extreme. We were lucky."
NYC's Thrive campaign is one that other cities can look toward for examples on how to talk about and act on mental health in general and maternal mental health in particular. With 54 initiatives (23 of which are brand new), Thrive is just the first step in what they want to do when it comes to mental health.