Health Policy| Volume 32, ISSUE 6, P644-647, November 2018

Access to Maternal Mental Health Services: Trends in State Legislation

      Postpartum depression is the most common but underrecognized medical complication of childbearing, and 10% to 15% of pregnant and postpartum women will experience depression. Currently, only 30.8% of women with postpartum depression are identified, and only 6.3% receive adequate treatment (
      • Cox E.Q.
      • Sowa N.A.
      • Meltzer-Brody S.E.
      • Gaynes B.N.
      The perinatal depression treatment cascade: Baby steps toward improving outcomes.
      ). Given this disparity in detection and treatment, women who suffer maternal mental health disorders need effective health policies to increase access to mental health services. This article presents a review of the risks of untreated maternal mental health disorders and an update on conventional state policies on maternal mental health and access to care and will conclude with a focus on two state-led policies with novel mechanisms for addressing maternal mental health and increasing access to mental health services.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Health Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Becker M.
        • Weinberger T.
        • Chandy A.
        • Schmukler S.
        Depression during pregnancy and postpartum.
        Current Psychiatry Reports. 2016; 18: 1-9
        • Byatt N.
        • Biebel K.
        • Moore Simas T.A.
        • Sarvet B.
        • Ravech M.
        • Allison J.
        • Straus J.
        Improving perinatal depression care: the Massachusetts Child Psychiatry Access Project for Moms.
        General Hospital Psychiatry. 2016; 40: 12-17
        • Byatt N.
        • Levin L.L.
        • Ziedonis D.
        • Moore Simas T.A.
        • Allison J.
        Enhancing participation in depression care in outpatient perinatal care settings: A systematic review.
        Obstetrics & Gynecology. 2015; 126: 1048-1058
        • California Task Force on the Status of Maternal Mental Health Care/2020 Mom
        A report from the California Task Force on the Status of Maternal Mental Health Care.
        Author, Los Angeles, CA2017 (Retrieved from)
        • Chan J.
        • Natekar A.
        • Einarson A.
        • Koren G.
        Risks of untreated depression in pregnancy.
        Canadian Family Physician. 2014; 60: 242-243
        • Cox E.Q.
        • Sowa N.A.
        • Meltzer-Brody S.E.
        • Gaynes B.N.
        The perinatal depression treatment cascade: Baby steps toward improving outcomes.
        The Journal of Clinical Psychiatry. 2016; 77: 1189-1200
        • Dembosky A.
        Lawmakers weigh pros and cons of mandatory screening for postpartum depression.
        NPR. 2018; (Retrieved from)
        • Gentile S.
        Untreated depression during pregnancy: Short- and long-term effects in offspring. A systematic review.
        Neuroscience. 2017; 342: 154-166
        • Henderson V.
        • Stumbras K.
        • Caskey R.
        • Haider S.
        • Rankin K.
        • Handler A.
        Understanding factors associated with postpartum visit attendance and contraception choices: Listening to low-income postpartum women and health care providers.
        Maternal and Child Health Journal. 2016; 20: 132-143
        • Highlet N.
        Valuing perinatal mental health: The costs of not treating perinatal depresion and anxiety.
        COPE Center of Perinatal Excellence, Flemington, Australia2014 (Retrieved from)
        • Hutchens B.
        • Belsito J.
        • Burkhard J.
        21st century cures act is a victory for the fight against maternal depression, now what..
        (Retrieved from)
        • Kartika T.
        Case study: How Minnesota uses Medicaid levers to address maternal depression and improve healthy child development.
        National Academy for State Health Policy, Washington, DC2017 (Retrieved from)
        • Kozhimannil K.B.
        • Adams A.S.
        • Soumerai S.B.
        • Busch A.B.
        • Huskamp H.A.
        New Jersey's efforts to improve postpartum depression care did not change treatment patterns for women on Medicaid.
        Health Affairs. 2011; 30: 293-301
        • Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, Boston
        Gold award: Building the capacity of frontline providers to treat mental and substance use disorders among pregnant and postpartum women.
        Psychiatric Services. 2017; 68: e1-e3
        • McLearn K.T.
        • Minkovitz C.S.
        • Strobino D.M.
        • Marks E.
        • Hou W.
        Maternal depressive symptoms at 2 to 4 months post partum and early parenting practices.
        Archives of Pediatrics & Adolescent Medicine. 2006; 160: 279-284
      1. Postpartum Support International. (n.d.). Pregnancy & postpartum mental health. Portland, OR: Author. Retrieved from

        • Revisor of Statutes
        2017 Minnesota Statutes: 145.906.
        Author, St. Paul, MN2017 (Retrieved from)
        • Rhodes A.M.
        • Segre L.S.
        Perinatal depression: A review of US legislation and law.
        Archives of Women's Mental Health. 2013; 16: 259-270
        • Rowan P.J.
        • Duckett S.A.
        • Wang J.E.
        State mandates regarding postpartum depression.
        Psychiatric Services. 2015; 66: 324-328
        • Smith S.
        • Granja M.
        • Ekono M.
        • Robbins T.
        • Nagarur M.
        Results of a 50-state survey.
        National Center for Children in Poverty, New York, NY2017 (Retrieved from)
        • Straus J.H.
        • Sarvet B.
        Behavioral health care for children: The Massachusetts Child Psychiatry Access Project.
        Health Affairs. 2014; 33: 2153-2161
        • Wachino V.
        CMCS informational bulletin on maternal depression screening and treatment: A critical role for Medicaid in the care of mothers and children. Centers for Medicare and Medicaid Services.
        Centers for Medicare & Medicaid Services, Baltimore, MD2016 (Retrieved from)
        • Yu M.
        • Sampson M.
        Closing the gap between policy and practice in screening for perinatal depression: A policy analysis and call for action.
        Social Work in Public Health. 2016; 31: 549-556


      My Hanh (Theresa) Nguyen, Clinical Assistant Professor, Hahn School of Nursing and Health Sciences, University of San Diego, San Diego, CA.


      Karen G. Duderstadt, Emeritus Clinical Professor and UC Chair CCGA 2017–2018, Department of Family Health Care Nursing, School of Nursing, University of California–San Francisco, San Francisco, CA.