Link: http://www.wsj.com/articles/a-new-york-initiative-to-promote-mental-health-1447813779?alg=y&cb=logged0.11785705516394024 

By Thomas MacMillan
November 17, 2015

Doctors in New York City will soon be asking new mothers some extra questions during medical visits. Along with “How’s your baby?” they’ll also ask, “And how are you?”

The new initiative to screen all pregnant women and new mothers for maternal depression was announced Tuesday by Chirlane McCray, Mayor Bill de Blasio’s wife, at a news conference at Bellevue Hospital.

The initiative is the first of a new city program called Thrive NYC, which aims to destigmatize mental illness and make mental health care more accessible. The full program will be unveiled in the next several weeks, said Ms. McCray, who has made mental-health advocacy her signature issue since her husband took office, and has spoken openly about her parents’ and daughter’s struggles with depression.

NYC Health + Hospitals and Maimonides Medical Center, who together perform about a quarter of the city’s deliveries, have committed to universal screening and treatment within two years, Ms. McCray said. 

Meanwhile, the Greater New York Hospital Association will work to sign up other hospitals, Ms. McCray said. Ken Raske, president of the association, said his organization is convening a task force of experts to come up with screening protocols to be shared among hospitals.

Deputy Mayor Richard Buery said treatment of maternal mental illness is covered by most insurance plans, including Medicaid, but is often an overlooked part of perinatal health care.

A state law that took effect last year brought more attention to postpartum mental illness, but has been criticized for not requiring screening.

Tuesday’s announcement comes after three cases in recent months of mothers charged with murder for allegedly dropping their babies out of windows. Mr. Buery stressed that it is unknown if these women suffered from maternal mental illness and said that women harming their children is exceedingly rare.

While postpartum psychosis, a more severe illness, is very uncommon, studies show that postpartum depression affects about one in 10 pregnant women and new mothers, officials said. “Here in New York City, that means 12,000 to 15,000 cases a year,” said Ms. McCray.

The actual numbers, however, may be higher, since many women, particularly black and Latina women, don't get treatment, she said.

“Depression, coupled with the stigma and fear of being labeled a bad mom, can keep women from reaching out for the help they need,” Ms. McCray said. 

Dr. Ram Raju, president of NYC Health + Hospitals, said physicians as well as mothers can be uncomfortable discussing mental illness.

He drew a comparison to the early days of the HIV health crisis, when HIV testing was a taboo subject. Public health education changed that, and made HIV screening a routine part of medical care, Dr. Raju said. “We can do the same for maternal depression.”

Martha Duff, a 35-year-old mother who lives in the East Village, attended Tuesday’s news conference with her 6-month-old daughter, Margot Adam. Ms. Duff said she sought help when she became depressed about a month into her pregnancy and is now being treated at Bellevue Hospital.

“I was experiencing really huge hormonal changes that brought on the depression,” she said. Therapy has helped her to return to her normal happy state, she said.

“The most important part of the treatment was that I was understood and met with respect and just really embraced here and made to feel normal, rather than abnormal,” Ms. Duff said. “Now I have a healthy new happy baby, and I’m doing well.”