0
0
University of Michigan Study Highlights Slow Progress in Addressing Mental Health Needs of New Mothers
A recent study published in JAMA Network Open reveals that pregnant and postpartum women suffering from depression and anxiety have slightly better access to psychotherapy services today compared to previous years. However, despite these improvements, significant gaps in care remain.
The study, conducted by the University of Michigan as part of the Maternal Behavioral Health Policy Evaluation (MAPLE) project, examined the impact of key health policies—the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2010 and the Affordable Care Act (ACA) of 2014—on mental health care for new mothers. Both laws were designed to reduce insurance-related barriers and promote equal coverage for mental and physical health care.
Incremental Gains in Access and Affordability
According to the study’s lead author, Dr. Kara Zivin, a professor at Michigan Medicine, the laws have led to some positive trends. “The gap between mental and physical health care closed slightly over time, and cost barriers decreased marginally,” Zivin noted. However, the improvements have been slow, likely due to a shortage of mental health providers, underdiagnosis of pregnancy-related mental health conditions, and ongoing stigma against seeking mental health care.
The study found that only about 10% of women with private insurance who were diagnosed with anxiety or depression during pregnancy or the postpartum period received psychotherapy between 2019 and 2020. This figure is concerning given that 25% of pregnant women and new mothers were diagnosed with at least one of these mental health conditions in 2019, up from 14% in 2007.
The Financial Impact
The analysis also highlighted variations in out-of-pocket costs for psychotherapy, with women paying more at the beginning of the year compared to the end. This seasonal variation, which became more pronounced after the ACA took effect, may be linked to the rise in high-deductible health plans that require insured individuals to cover the full cost of care until they meet their deductible.
Barriers Persist Despite Policy Changes
Despite the intentions behind the MHPAEA and ACA, barriers to accessing mental health care for new mothers persist. The study’s findings suggest that even among those who did receive care, many women had only one psychotherapy visit during the study period. This indicates that while insurance coverage has improved, it has not been sufficient to ensure consistent and comprehensive care for those who need it most.
The study analyzed data from over 716,000 women aged 15 to 44 who gave birth between 2007 and 2019, focusing on those with a mental health diagnosis during the two years surrounding their deliveries. However, the study did not include women covered by Medicaid, who account for 42% of births in the U.S. and tend to have lower incomes, nor did it include women who paid for psychotherapy out of pocket.
Future Directions and the Role of Telehealth
As the landscape of mental health care continues to evolve, especially with the expansion of telehealth during the COVID-19 pandemic, further research is needed to assess whether these new avenues have improved access to psychotherapy for pregnant and postpartum women. Dr. Zivin suggests that examining post-2020 data could shed light on whether telehealth has helped bridge the gap in areas with severe provider shortages.
In the meantime, addressing the shortage of mental health providers remains a critical challenge. The very issue that mental health parity laws aim to address—inequities in coverage for mental and physical health care—has contributed to the longstanding provider shortage.
This study underscores the need for continued efforts to ensure that all new mothers receive the mental health care they deserve, particularly as mental health challenges continue to rise. The researchers emphasize that while policy changes have made some difference, much work remains to be done to support the mental well-being of mothers and their babies.
