Everyone Can Be an Advocate!

Joy Burkhard

Together We Can Change the Face of Maternal Mental Health Care
Joy Burkhard, MBA

Care for Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this series.

At 2020 Mom, our name reflects one overarching goal: to close the gaps in maternal mental health (MMH) by the year 2020. Given what you’ve read in previous posts about the state of care, this may seem like an ambitious deadline, but we believe it is possible.

As a nonprofit maternal mental health advocacy organization, 2020 Mom is dedicated to offering tangible steps stakeholders can take to effect change. Since we launched in California in 2011, we’ve seen a groundswell begin to bubble up nationally. Providers, insurers, and health care systems are starting to recognize the magnitude of the gap in care when it comes to maternal mental health because of the work so many are doing.

Throughout this series, you’ve heard from experts about the prevalence of maternal mental health disorders like PPD, the barriers to care, and the negative effects of depression on moms and babies. You’ve also read how treatable these disorders are, how cost-effective care can be (especially through centralized treatment and training programs like MCPAP for Moms), and how legislation is the cornerstone of change. What you haven’t read much about is how you can help.

I’m here to emphasize the power of advocacy and leave you with a list of concrete ways you can make a difference for moms, babies, and families.

What We Do
At 2020 Mom, our mission is to close the maternal mental health care gaps through education, advocacy, and collaboration.

Along with our partner, Postpartum Support International (PSI), we developed web-based, maternal mental health training to address the shortage of training for health care providers. To date, over 800 providers have been trained.

Identifying and Sharing Best Practices with Key Stakeholders
Given that 99% of women deliver in hospital settings and that most have health insurance, we recognized that hospitals and insurers can play a critical role in solving the maternal mental health crisis. Therefore, we have studied and met with hospitals and insurers who have developed programs, combed the literature, and identified best practices that these organizations can use to create quality management action plans. For example, hospitals have a unique opportunity to inform their patients about maternal mental health disorders during birth classes and at discharge as well as offer information on local treatment options. Insurers have the opportunity to offer support in finding proper care and helping providers follow-up with mothers to be sure they are receiving treatment and have the resources they need. These types of case management programs are already provided for a number of temporary health conditions by insurers. These are just two examples of best practices highlighted in our “Whole Mom” hospital and insurer assessments.

Sharing Our Findings
Another important part of our efforts has involved sharing these practices and our findings widely through conference presentations, webinars, and other speaking engagements. For example, when health insurer Cigna adopted our best practice for monitoring screening rates among its OB/GYNs treating pregnant and postpartum women (using the Maternity Care measure developed by the American College of Obstetrics and Gynecology, the National Committee for Quality Assurance, and the American Medical Association), we learned that among the providers in the Cigna PPO network in California, only five percent of providers were screening pregnant women using a validated screening tool and only six percent were doing so postpartum. We have no reason to believe that these numbers would be any higher in other states or among the Medicaid population generally. Sharing these results with our audiences has led to deeper interest in addressing maternal mental health.

Advocacy and Collaboration
In California, with the financial support of the California Endowment and California HealthCare Foundation, we created a commission—the California Task Force on the Status of Maternal Mental Health Care—that’s studying the maternal mental health landscape in California and in other states that are leading the way. The Task Force will make legislative recommendations and recommendations for key stakeholders groups this May.

To tackle advocacy nationally, we host the National Coalition for Maternal Mental Health. It brings together multiple non-profits working to address maternal mental health in the US, including Postpartum Progress, MotherWoman, and PSI, as well as other state-based organizations and advocates. We work together on the national @MayCampaign, a collective social media awareness campaign that runs in May; meet with federal agencies and national non-profits serving mothers; and support federal legislation, including hosting a hearing and lobby day this April in DC on Capitol Hill.

Even with state and federal advocacy efforts like these in place, local communities must also be involved in implementing change. To that end, with the support of foundations who care about this issue (including the Ben and Lucy Ana Fund of the Walton Family Foundation), this year we have developed a toolkit that allows communities to create local action plans that emphasize stakeholder engagement and collaboration and a learning network that will allow these communities to connect and share ideas.

Congresswoman Clark’s legislation, “Bringing Postpartum Depression Out of the Shadows Act (H.R. 3235/S.2311) is crucially important when it comes to supporting change on a state-by-state basis. If it passes, states will have the opportunity to apply for funding to launch their own programs that address the unique needs of their states and communities, including centralized reproductive psychiatry access and provider training programs (like those modeled by MCPAP for Moms). With these multipronged approaches, it’s not hard to envision universal screening and maternal mental health care as an achievable goal.

How You Can Help

Lending Your Voice to Federal Legislation
Lend your voice in support of the “Bringing Postpartum Depression Out of the Shadows Act” (H.R. 3235/S. 2311) by contacting your Senators and Representative. The National Coalition for Maternal Mental Health offers a draft letter and talking points, as well as information about how to find out who your elected officials are and register for our national lobby day on April 5, 2016 in Washington, DC.

Taking Local and State Action
If you’re interested in spearheading the maternal mental health effort in your community, attend one of 2020 Mom’s complimentary webinars on how to host a stakeholder’s meeting. If you’re already part of an organization that’s ready to get involved (such as a local public health department or an early education/Head Start program), you can connect to other groups through the community coalitions learning network. In addition, the community action toolkit lays out easy action steps to address MMH.

Additionally, if you’re looking to engage with others in state-level advocacy, look at the White Paper issued by the California Taskforce on the Status of Maternal Mental Health Care. This will help you understand the policy and legislative opportunities that are universal to many states. Also, join the 2020 Mom e-newsletter list to learn how maternal mental health nonprofits will be supporting state advocacy platforms in the future.

Raising Awareness
If you’d like to raise awareness among women of childbearing age, consider forming a walking team (at a March of Dimes or AFSP Out of the Darkness walk, for example). You can use the universal blue dot awareness symbol on team t-shirts and pass out light blue balloons with awareness materials tied to the strings. 2020 Mom and the National Coalition for Maternal Mental Health both offer materials that can be customized with logos from local organizations.

Maternal Mental Health Moving Forward
Despite the many barriers to care, maternal mental health CAN be addressed by the year 2020 if we all play a part. The moms in our lives – both current and future – are counting on us to create their support system. Whether you’re a doctor, a survivor, or simply a concerned citizen, we need YOU to join us in the call for better care.

We’re honored that you’ve followed us for the duration of this important series. Please share these posts; leave your comments, stories, and suggestions; and offer your personal input so we can make this movement a collaborative, community effort.

Your Turn

  • What are you doing to advocate for better maternal mental health care in your community?


Joy Burkhard is a founder, Executive Director and Board Chair of 2020 Mom which is well known for its work closing gaps in maternal mental health care through convening, collaborating, advocacy and education. Ms. Burkhard help found the National Coalition for Maternal Mental Health which brings together leaders of non-profits focused on maternal mental health to engage in collective impact. She has addressed the National Institute of Health Fellows and sits on several steering committees including the California Maternal Quality Care Collaborative Executive Committee and the American College of Obstetrics and Gynecology working group on maternal depression. She has served as a Compliance Project Manager for Cigna for 20 years and has gained knowledge of the complexities of health care delivery systems. Before founding 2020 Mom, Joy had a rich volunteer life with the Junior League, serving most recently as the Junior Leagues of California State Public Affairs Committee Co-Chair and was recognized by the Junior League of Los Angeles in 2013 with their Founder’s Cup.

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