One in five California women experiences depression or anxiety during pregnancy or in the first year following childbirth, according to the California Task Force on the Status of Maternal Mental Health Care. That means at least 100,000 California women experience a maternal mental health disorder annually, and treatment happens in less than 15 percent of identified cases.
With a new law, AB 845, the Medical Board of California is required to consider including a course in maternal mental health in the Board’s continuing education requirements for licensed physicians and surgeons.
“There is not a lot of training available to professionals,” said Kara Cruz, a marriage and family therapist in Modesto who volunteers with Postpartum Support International. “And even mental health professionals often come out of school or come out of their education with little or even no perinatal mental health training.”
Suicide and drug-related deaths are two of the leading causes of death among new mothers in California, according to a 2019 study in the American Journal of Obstetrics and Gynecology. These deaths are often related to perinatal mental health, and one of the reasons why 2020Mom, a Los Angeles-based nonprofit dedicated to improving maternal mental health, sponsored AB 845.
“Legislators understand that without providing for moms we don’t have a thriving society in California,” said Joy Burkhard, founder and executive director of 2020Mom. “They’re really following a wave of not just better understanding maternal mental health care, but better understanding the needs around mental illness generally in the country and in our state.”
When this law passed in the summer, no legislators voted against it. Burkhard said there was no opposition because it wasn’t proposed as a mandate, which the Medical Board of California has historically opposed. 2020Mom also had a precedent from a preceding bill, AB 1340, that was passed in 2017 that required the Medical Board of California to consider adding training to recognize mental health issues in children and young adults to their continuing education requirements, which they did.
According to a Medical Board of California analysis, the board would need to consider adding continuing medical education courses on perinatal mental health under AB 845 that would address “best practices in screening for maternal mental health disorders, including cultural competency and unintended bias.” It would also discuss the range of maternal mental health disorders, the variety of evidence-based treatment choices and when a doctor should consult a psychiatrist instead of making a referral.
“In order for the Board to require physicians to take continuing medical education (CME) courses on perinatal mental health, there needs to be a legislative change that mandates the requirement,” said Emmalee Ross, an information officer with the Medical Board of California. “The Board is currently working on the implementation plan for AB 845.”
Burkhard said the new law will make a difference. “This is one more step in several steps that still have yet to be taken,” Burkhard said. “And it’s critical that our medical doctors have access to training to address maternal mental health in an effective way.”
This story is part of a collaborative project between McClatchy and seniors in the journalism program at Sacramento State University. For more information about the program, or to send a message, visit facebook.com/sacstatejournalism.