An analysis of maternal mental health care reports a grim reality: Maryland, as well as the rest of the United States, has only slightly improved its ability to care for the mental health and well-being of new mothers and pregnant people since last year.
States as a whole need to do much better, according to Joy Burkhard, executive director of the Policy Center for Maternal Mental Health.
“We’re seeing improvements overall, but really just incremental progress in the United States,” Burkhard said, following an updated “report card” measuring how states take care of maternal mental health.
This is the second year that the nonprofit graded states in a report card format on maternal mental health care, and the updated report concludes that states are overall “still failing mothers,” even though many states saw incremental improvements to their scores.
In 2023, Maryland was one of the top 10 states in maternal health care — but it still only received a C-, along with nine other states. Only California earned a B- in 2023.
This year, Maryland creeped up to a grade of C, due to new metrics involving insurance claims. Eight other states and Washington, D.C., also received a C in 2024.
Pennsylvania, Utah and Washington earned a B- from the group while California earned a B+, leaving Maryland on the lower end of the top 14 states in maternal mental health in 2024.
Policy Center on Maternal Mental Health gives Maryland a C in 2024. Courtesy of Policy Center on Maternal Mental Health
Burkhard noted that there’s “still a majority of the United States” that earned a D+ or lower score.
In 2023, there were 40 states that earned either a D or an F in maternal mental health. That number improved in 2024, when 29 states earned a D+ or lower.
Last year, United States received a D- overall on its report card; this year, the nation inched up to a D.
“But, we’re excited about the second round of report cards to highlight what’s actually happening, at the national level and at the state level,” Burkhard said.
The 2024 report cards were published just last week and coincided with the release of a new national strategy to improve maternal mental health across the United States.
The 94-page plan includes several goals to improve maternal mental health nationally, including increases in data collection on maternal mental health needs, improvements on access to services for struggling patients and additions to community support systems.
“Deaths from suicide, drug overdoses, and other causes related to mental health and substance use issues are the leading cause of pregnancy-related deaths in the U.S., accounting for more than 22% of those deaths,” according to a press release from the U.S. Department of Health and Human Services.
Burkhard said that ignoring maternal mental health has “a two-generation impact.”
“It’s significant. We should be really concerned about not only a mother’s suffering … but the fact that we may be impacting a baby,” she said.
“In the post-partum period, if the mother is the primary caregiver of this brand-new life, which is usually the case, then we should be really concerned if she is not thriving,” Burkhard explained. “If she’s suffering from anxiety, depression or the whole range of these disorders, which can include psychosis, OCD (obsessive-compulsive disorder), post-traumatic stress disorder related to birth trauma or lifetime trauma.”
Maryland Maternal Mental Health
The report focuses on several areas where states can improve maternal mental health access to services and health care coverage across the states.
Some metrics consider Medicaid coverage, access to maternal mental health providers, data from insurance coverage and claims for services, screening requirements for mental health needs.
One category assesses whether Medicaid requires screenings and data collection for mental health concerns such as prenatal depression and post-partum depression. Maryland Medicaid does not currently require those screenings, bringing the state’s score down in that category.
Another category assesses the state programs available and whether those suffering maternal mental health needs have reasonable.access to providers.
Burkhard said that Maryland does not have enough certified maternal mental health providers for the perinatal population, also pulling its ranking down compared to other states.
The report also docks Maryland points for its lack of an inpatient treatment program specifically focused on maternal mental health for those who may be struggling with substance misuse while pregnant or shortly after giving birth.
Burkhard noted Maryland was forward-thinking in creating a state task force to study maternal mental health, which helped its score. The Maryland General Assembly passed legislation to create the task force in 2015.
In addition, Maryland had already garnered some points last year for previous Medicaid expansion efforts and ensuring that those on Medicaid are covered for up to one year post-birth.
What helped Maryland slightly improve its grade in 2024 is a metric about insurance claims.
“We are now measuring, through claims data, is how often providers are submitting claims for screening,” Burkhard said. “That means they’re submitting claims for reimbursement, which is one way to determine how often that screening might be happening. And we did see a little bit of improvement there, and so Maryland received points for that.”
Based on the report, Maryland could increase its maternal mental health screenings overall to boost its score further next year.
“Once you require screening, reporting on screening, generally it becomes a bigger priority and health plans take more actions to support providers in the network around screening,” Burkhard said.
Recently approved legislation could help on that front.
Gov. Wes Moore (D) signed HB 1051 on Thursday, which increases reporting requirements for hospitals, birthing facilities and local health departments to report data on various indicators of maternal health across the state.
Del. Jennifer White Holland (D-Baltimore) on March 12, 2024. Photo by Danielle J. Brown
Part of the legislation requires that hospitals and free-standing birthing clinics report on referrals for a variety of “high-risk” pregnancy situations, which include services for mental health needs and substance misuse, among other postpartum complications.
Del. Jennifer White Holland (D-Baltimore) was the lead sponsor of the legislation.
“Thinking about how we look at maternal mental health, knowing that we have so much more work to do, this bill is just a start. It is not the only solution,” White Holland said Friday.
“It’s truly about making sure that the birthing parent and their families have the necessary resources available to them in the community,” she said. “That there’s that warm connection or handhold to make sure that they have the resources that they need.
“This is a starting point. But there has to be more attention on it,” White Holland said.
The post Report: Md. shows ‘incremental’ gains on maternal mental health, but still needs work appeared first on Maryland Matters.