We are thrilled to share the news about the Perinatal Mental Health Expansion Initiative within the New York City (NYC) Early Childhood Mental Health Network! This initiative marks a significant leap forward in the NYC Department of Health and Mental Hygiene’s commitment to supporting pregnant people and parents during their transition to caring for children.

A Dynamic Journey
Pregnancy is not only a biological process – it is a period of profound transformation for the pregnant person, their partner, and their family. The physiological, psychological, and relational changes that accompany pregnancy demand a reorganization of personal identity that can be destabilizing. Prospective parents may shift from individual goals to the all-consuming care of their new baby. Some prospective parents may face dealing with perinatal loss and grief. Many new parents grapple with the structural and emotional pressure of caring for infants without having the necessary supports to care for themselves, such as paid leave or childcare. All families face challenges around the birth of a child.

Navigating Challenges
Imagine anticipating the joy of welcoming a new life but instead feeling overwhelmed by anxiety, sadness or even despair. Unfortunately, this is the reality for many pregnant and postpartum people in NYC, particularly those facing structural inequalities. The journey of gestation, childbirth and caregiving is not solely determined by individual experiences – it is deeply shaped by the broader context of social determinants of health. Lack of access to basic resources, health care segregation, structural racism and discrimination create significant barriers for pregnant people and parents, which impacts their well-being and exacerbates risk factors for perinatal mood and anxiety disorders (PMADs). Extensive research across disciplines points to a stark truth: the chronic stress of systemic racism, which is deeply embedded in our societal, institutional, and interpersonal fabric, intertwines with historical and ongoing disinvestment in communities of color (such as redlining, predatory housing policies, and unequal funding for schools and hospitals). These forces act in concert to represent the root causes of pervasive health inequities, including the disproportionate burden of PMADs faced by Black mothers and other marginalized communities. Addressing these systemic inequities is crucial to building a more equitable and supportive environment for families during this pivotal phase of life.

PMADs: A Call to Action
There were 100,022 live births in NYC in 2020. Out of these births, half were to birthing people who live in disinvested neighborhoods and utilize public health insurance (Summary of Vital Statistics: 2020). This population faces significant risk factors for PMADs. Research from the Centers for Disease Control and Prevention (CDC) shows about one in eight people experience symptoms of postpartum depression in the U.S. (Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018). Additionally, behavioral health (suicide and overdose) is a leading cause of maternal mortality in NYC, disproportionately impacting Black mothers (Pregnancy-Associated Mortality in New York City, 2020). These sobering statistics underscore the urgency of our mission to elevate perinatal mental health support, responding comprehensively to the diverse needs of our community.

Early Childhood Mental Health (ECMH)'s Expansion for Perinatal Populations
The ECMH Network is thrilled to embark on a transformative journey, expanding its mental health services to cater to the perinatal (pregnant and 12-month postpartum) population. Understanding the unique challenges and opportunities during this period, we are adding dedicated perinatal mental health practitioners to our clinical team, allowing us to reach more people in need of quality care. Our highly trained ECMH Network clinic staff, including social workers, mental health counselors, and marriage and family therapists, are equipped with specialized therapeutic models, such as Interpersonal Psychotherapy and Perinatal Child-Parent Psychotherapy. These evidence-based therapies, which are offered both remotely and in person, address anxiety, depression, traumatic stress, and adverse life experiences that can impact not only pregnant people but also their babies. We conduct comprehensive screenings to understand people’s individual needs and develop personalized treatment plans that address concerns such as anxiety, depression, stress, and trauma. Moreover, our services are offered in multiple languages, and our clinicians have extensive experience working with families from diverse cultural backgrounds.

Strengthening Collaborations for Comprehensive and Coordinated Care
A robust referral system is at the heart of our collaborative approach. Families in need of mental health care must be linked to care if they will benefit from treatment. This initiative enhances capacity and coordination among existing NYC Health Department programs serving pregnant people and new families, including the New Family Home Visits Initiative, Nurse-Family Partnership, Citywide Doula Initiative, Family Wellness Suites, Healthy Start Brooklyn, Healthy Women, Healthy Futures, and the Neighborhood Health Action Centers. Home visitors and doulas in these programs are being trained to recognize, screen, and refer to care. Social workers on these teams are being trained in evidence-based short-term interventions they can deliver directly. By connecting people identified through these programs to comprehensive and timely mental health support, we aim to create a network of care.

In recognition of the incredible diversity of our community, the ECMH Network is intensifying perinatal mental health-specific training through its ECMH Training and Technical Assistance Center (TTAC). This initiative equips mental health practitioners, community health workers, nurses, doulas, and lactation counselors with the knowledge and skills needed to recognize and respond to mental health and substance use needs in an evidence-informed, culturally appropriate, and equity-focused way. Together, these efforts create an inclusive and supportive ecosystem for families navigating the perinatal period.

Embarking on a Collective Journey
As we embark on this exciting journey to elevate perinatal mental health support, we acknowledge the collective responsibility to create a compassionate and equitable environment for all people. Our partnerships are invaluable as we strive to ensure the well-being of pregnant and postpartum people, babies, and families.

For referral information for the clinics, visit ttacny.org/clinical-services.

For information about TTAC webinars on perinatal mental health, visit ttacny.org/trainings.