Dartmouth Health Children's Takes Innovative Step in Maternal Mental Health

A first-in-the-nation position plays a key role in helping new moms who are struggling with mental health conditions.

Dartmouth Health Children's has created what it says is the first maternal mental health navigator role in the nation.

Mental health can be a challenge for new moms. Their mental health conditions include anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder. Mental health conditions are a leading cause of suicide among new moms.

"Recognizing that these conditions can be treated is a huge part of the puzzle for new moms—many of them do not recognize that they are experiencing a maternal mental health disorder," says Heather Martin, the new maternal mental health navigator at Dartmouth Health Children's.

Martin is serving in a year-long pilot program that began three months ago. The position is being funded through a philanthropic fund maintained by Dartmouth Health.

"The main goal of funding Heather's position was to test and pilot as well as create a model that is sustainable by figuring out the billing, figuring out the processes of interacting with obstetrics, and making sure you are protecting maternal privacy," says Julie Bosak, DrPH, a certified nurse-midwife at Dartmouth Hitchcock Medical Center and director of the New Hampshire Perinatal Quality Collaborative and the Northern New England Perinatal Quality Improvement Network.

The maternal mental health navigator role involves several responsibilities, including connecting struggling new moms with resources in the community, arranging peer support, providing strategies to cope with anxiety and stress, and supporting pediatricians and obstetricians who work with new moms.

Martin has a designated resource list, which includes mental health centers such as the Mental Health Center of Greater Manchester and psychiatrists at Dartmouth Health.

Dartmouth Health has been screening new moms for mental health conditions for five years.

"It is a quick questionnaire on a tablet, and moms do it before a baby visit," Martin says. "If that questionnaire comes back positive, and if a mom is open to help, resources, or just talking with me, they get connected to me and connected to resources such as therapy. Sometimes, the moms just talk with me and have someone to listen to their concerns."

Martin also plays a role in preventative care.

"Heather is able to work with moms before a condition escalates and becomes overwhelming," Bosak says.

The maternal mental health navigator position was created as part of Dartmouth Health Children's recognition that the postpartum period can be difficult for new moms and their families.

"Beyond the diagnoses, it is important for new moms and families to recognize that the postpartum period can be an emotionally challenging time," says Erik Shessler, MD, associate medical director at Dartmouth Health Children's. "You are in the hospital, you come home, and you are going to be sleep-deprived. We let new moms know that we expect them to be emotional and that we are here to help."

Heather Martin is the new maternal mental health navigator at Dartmouth Health Children's. Photo courtesy of Dartmouth Health.

Creating and expanding maternal mental health navigators

Dartmouth Health Children’s identified the need for a maternal mental health navigator through its screening program.

"We started asking questions, having some data showing that there was a need for services, and creating resources to support those needs that were identified," Shessler says.

The pilot program will hopefully serve as a springboard for similar programs across New Hampshire, he adds.

"We are going to have data that shows the maternal mental health navigator makes a difference because it has an impact on metrics and outcomes," Shessler says. "Then we will be able to bring this model across the Dartmouth health system and across the state."

Shessler also has national aspirations for the program.

"It is our hope that other health systems and children's hospitals across the country will adopt maternal mental health navigators," Shessler says. "There are some other health systems in the state that are doing screening as a first step. They are having their healthcare professionals increase their awareness, and they are conducting screening in either obstetrics care or pediatric care."