New York experts feel more must be done to improve maternal mental health, after the pandemic caused nationwide maternal mental health declines.

In New York, poor perinatal mood and anxiety disorders are a leading factor in maternal mortality and increasing attention to the illnesses has not reduced the stigma surrounding them.

Paige Bellenbaum, founding director of The Motherhood Center of New York, said romanticized ideals of the "perfect mother" make it hard for people to talk about their feelings.

"If they are to tell anybody how they are feeling and that they're struggling with their mental health at a time that is meant to be joyful, blissful, beautiful and amazing, that they will be judged," Bellenbaum observed. "Or their greatest fear is, 'If I tell anyone how I'm actually feeling, they might take my baby away.'"

The Motherhood Center of New York offers services to ensure birthing people can access care when needed, including access to perinatal therapists and reproductive psychiatrists, along with intervention services. Bellenbaum is also part of New York's Maternal Mental Health Working Group, which is developing recommendations to improve maternal mental health outcomes. She noted those will be made public by year's end.

Medications to treat postpartum depression have improved since first being made available in 2019. The first treatment was administered as a continuous infusion over almost three days in a hospital.

Dr. Donna O'Shea, OB/GYN and chief medical officer for population health at UnitedHealthcare, said newer medicines take far less time to be just as effective.

"This year, Zurzuvae is an option that is in pill form that's taken daily for two weeks and to make a difference in three days," O'Shea explained. "There are many different treatments and paths a woman can go, depending on the severity of her symptoms."

She added women should also look to their health insurance to see if there are options for maternal mental health care available, including Employee Assistance Programs, which can be highly beneficial. People should be able to call a listed number to speak with a behavioral health clinician as often as they need when they need it for no additional cost.

The growing crisis in Ohio's child welfare system is drawing attention, particularly for its impact on children's mental health.

Across the state, children with complex behavioral needs are struggling as placement options shrink and demand for specialized care reaches an all-time high.

Lindsay Sparks, protective services administrator for the South Central Ohio Job and Family Services, Children's Division & Adult Protective Services, noted that despite efforts with mental-health providers, many agencies lack the resources to handle severe cases.

"We have had a young child, under the age of 10, who we have about 45 denials across the state, they feel that they cannot meet that child's needs," she said. "Children have had to spend the night at our agency. That is not ideal for our children, for our staff, for anyone - but it has happened."

In some cases, Sparks added, agencies are forced to seek out-of-state placements - which can further complicate care for children already facing significant challenges. Recruitment efforts for foster families are ongoing, but the gap remains wide.

The crisis extends beyond placement shortages to escalating mental health concerns. Jody Walker, executive director of South Central Ohio Job and Family Services, highlighted how these issues have worsened over the past decade.

"The types of children that we're seeing coming into care, that have more severe behavioral mental health issues, and our system really hasn't been able to keep up with types of placements that benefit these kids the most," he said. "The cost for those placements went up, at the tune of 300% in the last 10 years."

As Ohio faces rising costs and limited resources, the County Commissioners Association has made child welfare a top priority in the upcoming biennial budget. The association is applauding Governor Mike DeWine's commitment to children, and stresses that counties play a vital role in protecting them.

As mental health challenges continue to rise among young people, advocates across North Carolina are pushing for increased access to mental health services in schools.

They are watching the upcoming election for North Carolina Superintendent of Public Instruction closely.

Kathleen Daughety, vice president of campaigns and engagement for the mental health advocacy organization Inseparable, said the outcome could significantly help fill gaps in access to mental health services for children across the state.

"Increasing access to mental health care is our focus because half of people in the US who need mental health care are not getting it today," Daughety pointed out. "That number is even worse for children; 70% of children who need mental health care aren't able to access it."

A recent poll by Inseparable showed it is an issue resonating with voters. About 88% believe expanding mental health care access should be a top priority for elected officials.

Graham Palmer, director of systems innovation and policy for the nonprofit Rural Opportunity Institute, explained barriers like broadband and workforce shortages and limited funding make it difficult to provide the necessary services, especially in rural areas. He believes schools can make a life-changing difference for kids.

"Sometimes schools are the only access point that systems of care can get to for kids, because there's transportation challenges," Palmer explained. "There may be time challenges, if the student has a job or they just don't have extra time to be driving an hour to see a therapist."

The Superintendent of Public Instruction would play a key role in shaping school policies, funding, and resources directly affecting whether schools can provide mental health services. The Democratic candidate, Maurice "Mo" Green recently signed Inseparable's "Mental Health Now" statement of support. He worked as the superintendent of North Carolina's third-largest school district and pointed out addressing the workforce is going to be crucial to giving students the support they need.

"The school psychologist's major association would recommend a ratio of about one school psychologist," Green noted. "For every 500 students, in North Carolina that ratio is almost 1 to 1,800."

Green is facing off against Republican nominee Michelle Morrow, who is a nurse and homeschool educator in Wake County. Her campaign website shows she supports school choice and increasing school resource officers.

Advocates are also calling for state policymakers to invest in expanded school-based mental health programs and improve crisis response efforts.


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Parents in North Dakota are likely getting a sense of how their child's school year is going so far. If bullying issues have emerged, the research community hopes educators and families take a careful approach to achieve better outcomes now and in the future.

Throughout Bullying Prevention Month in October, messaging on this topic is likely to be prominent in school settings.

Shelley Hymel, a retired developmental and educational psychologist and professor at the University of British Columbia has done extensive research in this field. She said it's no surprise that repeated bullying can negatively affect a student's academic performance, and how they deal with problems the rest of their lives.

Hymel wants anyone who still thinks it makes a child more resilient to think again.

"Kids who are victimized, you know, just sit there all day wondering what's going to happen to them next. I've had notes from kids saying how that's their life, that's how their world is," she said.

Hymel said that's why it's important for schools to not lose sight of social and emotional learning and teach children empathy. North Dakota law requires districts to adopt a bullying policy and explain it to students. On its website, the Department of Public Instruction offers guidance for parents, including listening calmly and offering comfort and support if their child says they're being targeted.

Hymel said researchers are still finding new tidbits of information, even after schools have adopted successful approaches. For example, in school settings where bullying was significantly reduced, the few remaining students still being singled out had it even worse.

"When you end up being the last kid, the one kid who was still being bullied, it takes a toll on your self esteem," she explained.

That's why the academic community, schools, and parents need to remain vigilant about overcoming any side effects as policies take shape, she added. Earlier this year, British researchers released findings showing bullying in childhood lowers the probability of having a job throughout adulthood, and puts a person at greater risk for premature death.


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