We Screen Moms. Then What?
New Jersey was one of the first states to require that every new mother be screened for postpartum depression before she leaves the hospital. I helped build that. I’m proud of it.
Here’s what the law didn’t say. It didn’t say what to do with the score. It didn’t say whether a 10 out of 30 means something different from a 20. It didn’t say who follows up, or when, or where she goes. It said: screen her. That’s it.
As a nurse on the floor, I handed moms the Edinburgh, got it back, and saw a 14. I asked what to do. One answer I got: fax it to this number.
That was years ago. Today hospitals still use different cutoffs. Some call social work at 10. Some at 13. Some only act if she answers yes on question 10, the self-harm question. There’s no national standard, and the major medical associations each recommend something slightly different.
Now more states are passing screening laws. Good. But a screen is a question. Treatment is the answer. Nobody would accept being screened for breast cancer and then sent home with a phone number.
This year’s state report cards gave the country a C overall. The same release found 45 states have no inpatient maternal mental health program and 47 don’t have enough specialized therapists. That’s the part worth reading twice.
Look at what earns a state points, though. Data collection requirements. Task forces. A consultation line an OB can call to ask a psychiatrist a question. Those things have their place. But a mom in crisis at 2 a.m. doesn’t need a task force. She needs a place to go, with people who know what this is, who will see her this week.
My program doesn’t count as a “perinatal psychiatry consultation program” on that scorecard. We don’t need one. We have perinatal psychiatric nurse practitioners on staff who see the patients themselves. We are the consultation. That’s not on the form.
We’ve spent 15 years on awareness and policy. The next 15 have to be about care: centers, in real communities, that take insurance and treat the whole mom.
That’s what Bloom is for. We give practices and hospitals the full playbook to build one. If you’ve been screening for years and wondering “then what?”, let’s talk.