As more babies are born during September than almost any other month, experts are calling attention to the critical need for postpartum depression resources.

For many new mothers, this time of joy is often accompanied by feelings of isolation and mental health challenges.

Corrina Edwards, a licensed midwife, stressed the complexity of postpartum depression and the importance of individualized care for each mother, from alternative and more holistic care, even traditional medicines. She said overall, it is essential to be mindful of each option for the health and safety of both mother and child.

"At the end of the day, your sanity matters, and at the end of the day, if you can take care of yourself and love yourself, you're going to be that much better of a mother to your baby," Edwards emphasized. "You're going to be that much more present for your new baby and for your family."

Symptoms of postpartum depression may include feeling persistently angry or sad, having trouble bonding with your baby, insomnia, and loss of appetite. About one in eight new mothers report having these symptoms, and the rate of women diagnosed at delivery was seven times higher in 2015 than in 2000, according to the Centers for Disease Control and Prevention.

Dr. Donna O'Shea, OB/GYN and chief medical officer for population health at UnitedHealthcare, said risk factors include any woman with a history of anxiety or mood disorders and a family history of depression. She added women from under-resourced communities are also at risk.

"The problem is that there are communities, such as or particularly in communities of color, where the stigma and judgment can prevent people from seeking the mental health treatment that can help them feel better," O'Shea outlined.

O'Shea highlighted new treatments including a pill called zuranolone are available to treat severe postpartum depression. She also encouraged new moms to talk about how they feel with family, friends and their health care provider, even when it is tough, and monitor mood changes.

By Cheryl Platzman Weinstock for KFF Health News.
Broadcast version by Kathleen Shannon for Wyoming News Service reporting for the KFF Health News-Public News Service Collaboration

When Pooja Mehta’s younger brother, Raj, died by suicide at 19 in March 2020, she felt “blindsided.”

Raj’s last text message was to his college lab partner about how to divide homework questions.

“You don’t say you’re going to take questions 1 through 15 if you’re planning to be dead one hour later,” said Mehta, 29, a mental health and suicide prevention advocate in Arlington, Virginia. She had been trained in Mental Health First Aid — a nationwide program that teaches how to identify, understand, and respond to signs of mental illness — yet she said her brother showed no signs of trouble.

Mehta said some people blamed her for Raj’s death because the two were living together during the covid-19 pandemic while Raj was attending classes online. Others said her training should have helped her recognize he was struggling.

But, Mehta said, “we act like we know everything there is to know about suicide prevention. We’ve done a really good job at developing solutions for a part of the problem, but we really don’t know enough.”

Raj’s death came in the midst of decades of unsuccessful attempts to tamp down suicide rates nationwide.

During the past two decades federal officials have launched three national suicide prevention strategies, including one announced in April.

The first strategy, announced in 2001, focused on addressing risk factors for suicide and leaned on a few common interventions.

The next strategy called for developing and implementing standardized protocols to identify and treat people at risk for suicide with follow-up care and the support needed to continue treatment.

The latest strategy builds on previous ones and includes a federal action plan calling for implementation of 200 measures over the next three years, including prioritizing populations disproportionately affected by suicide, such as Black youth and Native Americans and Alaska Natives.

Despite those evolving strategies, from 2001 through 2021 suicide rates increased most years, according to the Centers for Disease Control and Prevention. Provisional data for 2022, the most recent numbers available, shows deaths by suicide grew an additional 3% over the previous year. CDC officials project the final number of suicides in 2022 will be higher.

In the past two decades, suicide rates in rural states such as Alaska, Montana, North Dakota, and Wyoming have been about double those in urban areas, according to the CDC.

Despite those persistently disappointing numbers, mental health experts contend the national strategies aren’t the problem. Instead, they argue, the policies — for many reasons —simply aren’t being funded, adopted, and used. That slow uptake was compounded by the covid-19 pandemic, which had a broad, negative impact on mental health.

A chorus of national experts and government officials agree the strategies simply haven’t been embraced widely, but said even basic tracking of deaths by suicide isn’t universal.

Surveillance data is commonly used to drive health care quality improvement and has been helpful in addressing cancer and heart disease. Yet, it hasn’t been used in the study of behavioral health issues such as suicide, said Michael Schoenbaum, a senior adviser for mental health services, epidemiology, and economics at the National Institute of Mental Health.

“We think about treating behavioral health problems just differently than we think about physical health problems,” Schoenbaum said.

Without accurate statistics, researchers can’t figure out who dies most often by suicide, what prevention strategies are working, and where prevention money is needed most.

Many states and territories don’t allow medical records to be linked to death certificates, Schoenbaum said, but NIMH is collaborating with a handful of other organizations to document this data for the first time in a public report and database due out by the end of the year.

Further hobbling the strategies is the fact that federal and local funding ebbs and flows and some suicide prevention efforts don’t work in some states and localities because of the challenging geography, said Jane Pearson, special adviser on suicide research to the NIMH director.

Wyoming, where a few hundred thousand residents are spread across sprawling, rugged landscape, consistently ranks among the states with the highest suicide rates.

State officials have worked for many years to address the state’s suicide problem, said Kim Deti, a spokesperson for the Wyoming Department of Health.

But deploying services, like mobile crisis units, a core element of the latest national strategy, is difficult in a big, sparsely populated state.

“The work is not stopping but some strategies that make sense in some geographic areas of the country may not make sense for a state with our characteristics,” she said.

Lack of implementation isn’t only a state and local government problem. Despite evidence that screening patients for suicidal thoughts during medical visits helps head off catastrophe, health professionals are not mandated to do so.

Many doctors find suicide screening daunting because they have limited time and insufficient training and because they aren’t comfortable discussing suicide, said Janet Lee, an adolescent medicine specialist and associate professor of pediatrics at the Lewis Katz School of Medicine at Temple University.

“I think it is really scary and kind of astounding to think if something is a matter of life and death how somebody can’t ask about it,” she said.

The use of other measures has also been inconsistent. Crisis intervention services are core to the national strategies, yet many states haven’t built standardized systems.

Besides being fragmented, crisis systems, such as mobile crisis units, can vary from state to state and county to county. Some mobile crisis units use telehealth, some operate 24 hours a day and others 9 to 5, and some use local law enforcement for responses instead of mental health workers.

Similarly, the fledgling 988 Suicide & Crisis Lifeline faces similar, serious problems.

Only 23% of Americans are familiar with 988 and there’s a significant knowledge gap about the situations people should call 988 for, according to a recent poll conducted by the National Alliance on Mental Illness and Ipsos.

Most states, territories, and tribes have also not yet permanently funded 988, which was launched nationwide in July 2022 and has received about $1.5 billion in federal funding, according to the Substance Abuse and Mental Health Services Administration.

Anita Everett, director of the Center for Mental Health Services within SAMHSA, said her agency is running an awareness campaign to promote the system.

Some states, including Colorado, are taking other steps. There, state officials installed financial incentives for implementing suicide prevention efforts, among other patient safety measures, through the state’s Hospital Quality Incentive Payment Program. The program hands out about $150 million a year to hospitals for good performance. In the last year, 66 hospitals improved their care for patients experiencing suicidality, according to Lena Heilmann, director of the Office of Suicide Prevention at the Colorado Department of Public Health and Environment.

Experts hope other states will follow Colorado’s lead.

And despite the slow movement, Mehta sees bright spots in the latest strategy and action plan.

Although it is too late to save Raj, “addressing the social drivers of mental health and suicide and investing in spaces for people to go to get help well before a crisis gives me hope,” Mehta said.


Cheryl Platzman Weinstock wrote this story for KFF Health News.


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September is Suicide Prevention Month, and a St. Louis doctor says there is hope for people experiencing postpartum depression.

One in five women experiences pregnancy-related mental-health conditions, making them some of the most common complications during and after pregnancy. It's more than just the "baby blues"; some 20% consider suicide or self-harm.

Dr. Daniel Wagner, a board-certified obstetrician and gynecologist at St. Luke's Hospital in St. Louis, said it is important for doctors to properly assess what's going on with their patients and then talk about treatment.

"Sometimes, that's an easy and simple thing, whether it's just what we call psychotherapy or talk therapy," he said. "And then sometimes, you have to use medical therapy or medication, and it works extremely well for, really, almost the majority of all the patients."

Statistics show the stigma surrounding mental health often prevents individuals from seeking help. But last summer, the Food and Drug Administration approved a postpartum depression medication in pill form, called zuranolone, which can be taken at home.

Mental-health experts say the most important things to understand are that it's OK to ask for help - and it's normal to feel increased anger, sadness or anxiety with a new baby.

Dr. Donna O'Shea, chief medical officer for population health at UnitedHealthcare, said trusted family and friends are also good resources for people struggling with postpartum depression.

"And they can help you get some chores done, and let you get some rest, because the most important thing is that you recognize it early and act on it early," said O'Shea, "and maybe recognize as a sign of strength that you can say, 'Oh, I can use help - and that will be better for me, and for my baby.'"

O'Shea added that many workplaces offer Employee Assistance Programs that provide confidential access to behavioral health services, as well.

A new Healthy Minds Study finds college students' mental health in Connecticut and nationwide is improving.

In the last ten years, there have been significant increases in anxiety, depression, and suicidal thoughts.

But the change in this trend is being attributed to increasing attention to student mental health, with schools providing greater access to mental health care and resources.

Erin Voichoski, research area specialist with the Healthy Minds Network, said students are also seeing increases in positive mental health.

"Students feel like they are actively contributing to the happiness of others," said Voichoski. "They feel that they are competent and capable in things that interest them. They feel optimistic about their future. They feel like they are a good person and live a good life. Those are things that can coexist sometimes, with symptoms of depression and anxiety."

The researchers also found increasing use of therapy and medication among college students. Along with this, personal and public stigma about students' mental health has remained low.

Colleges and universities across Connecticut received grant funding for mental health services through the state's Higher Education Mental Health Services Initiative.

The report also notes loneliness in college students is declining, after reaching great heights during the pandemic. Voichoski said she feels the trend is promising, although the level is still quite high.

She said there are several takeaways for campus officials to keep in mind.

"We have the data," said Voichoski. "We've established that there is a need for these services and resources on college campuses, and the people who are making decisions on these campuses need to continue collecting data that can inform their decisions."

Voichoski said she feels having this kind of data ensures schools know how best to spend money on mental health resources for their students.

While the improvements are small so far, she said continued conversations about mental health can go a long way to help end the stigmas.