The Perinatal Psychiatry Clinic is a specialized destination clinic designed to provide state-of-the-art assessment, support and therapeutic intervention services to women throughout the reproductive life cycle.
COVID-19 UPDATE: The Zero to Thrive team is committed to supporting perinatal women during the coronavirus pandemic. For more information and a list of resources for pregnant, postpartum, and breastfeeding mothers, please click here
The Women and Infants Mental Health Program at the University of Michigan Department of Psychiatry was created to identify and address the unique needs of women and infants throughout the life cycle. Our program consists of outpatient clinical care, research, training education, and outreach, focused on improving and maintaining the mental health of women and infants. All program activities contribute to our overall mission to improve understanding, treatments, and outcomes for women and their families.
When it comes to mental health, women have unique needs and experiences, and many women experience challenges at times of hormonal changes and life transitions, especially during pregnancy, postpartum and perimenopause. Many women experience mood, anxiety, or trauma-related difficulties during these times and are in urgent need of time-sensitive, safe and effective specialized care.
The Perinatal Psychiatry Clinic is a specialized destination clinic designed to provide state-of-the-art assessment, support and therapeutic intervention services to women throughout the reproductive life cycle. The clinic has a particular focus on pregnancy and postpartum and is aimed at improving and maintaining the mental health and well-being of mothers and their families.
1 in 5 women struggle with mood issues in pregnancy and postpartum. Many feel alone and stigmatized. The Perinatal Psychiatry Clinic connects women with safe and effective treatments and the care they deserve.
Perinatal Dialectical Behavior Therapy Group
Parenting and pregnancy are both intensely rewarding and emotionally demanding experiences that can be especially difficult for parents with depression, anxiety, and trauma. In turn, this can impact their ability to respond sensitively to the high emotional needs of young children.The Perinatal Dialectical Behavior Therapy group is an adaption of Marsha Linehan’s current DBT group model and is designed specifically for pregnant and postpartum women. This adaptation provides psychotherapy that is accessible, supportive, and sensitive to the unique needs of women during the perinatal period and offers concrete therapeutic skills that target frequent areas of difficulty in the perinatal and early parenting period. The unique needs of this time in a woman’s life include biological changes impacting mood regulation and frustration tolerance, changes in interpersonal relationships and support networks, responding sensitively to the cues of the infant or young child as well as the challenge of attending to multiple needs of individuals and family members. With a focus on emotion regulation and coping skills that promote mothers’ mental health, peer support, parenting competence, and parent-child relationships, the Perinatal DBT group ultimately seeks to prevent recurrence of mental health episodes in mothers and the inter-generational transmission of risk and trauma to their children.The intervention aims to increase treatment engagement and adherence, improve coping skills for handling life stressors, decrease maternal anxiety and depressive symptoms and improve caregiving competence between mother and child. Perinatal DBT has the potential to reduce costs of care by reducing emergency service utilization for maternal mental health problems, preventing the transmission of risk and onset of socio-emotional and behavioral problems in children of mothers with trauma, mental health concerns, providing a cost-effective, sustainable, and accessible treatment model for perinatal women that can be delivered by community agencies throughout the State of Michigan.
Perinatal Adjustment Group
While pregnancy and new motherhood can be times of excitement and joy for many families, mood and anxiety symptoms are not uncommon. Many women feel isolated and alone with these struggles. A group approach to care during this time helps many women gain social support and can reduce guilt and stigma that can accompany these challenges. The Perinatal Adjustment Group was developed by expert perinatal researchers and clinicians at Zero to Thrive to provide an essential resource for mothers in our community. It is a 7-week skills-based psychotherapy group for pregnant and postpartum women (up to 1 year post-birth) who are experiencing adjustment disorders or mild to moderate symptoms of anxiety or depression.The Perinatal Adjustment Group provides evidence-based skills, education, and social support that can both treat and prevent worsening of symptoms and reduce the likelihood of recurrences. Facilitated by experienced perinatal mental health clinicians, the Perinatal Adjustment Group is a place where women learn about perinatal mood and anxiety disorders along with communication skills, cognitive reappraisal, relaxation and coping strategies. The group also helps women to understand the transitions of motherhood as well as changes in relationships and one’s identity.Unique to our program, mothers are not only welcomed, but encouraged to bring their infants and young toddlers to the group. Additionally, in order to accommodate the nature of pregnancy, delivery and physical recovery, the Perinatal Adjustment group is designed to run in a 7-week rotation where mothers can drop in and out of the group as needed, and may repeat the sessions as desired. In these ways mothers are supported and nurtured through this unique psychotherapy group.
Patients interested in participating must complete a New Patient Psychiatric Evaluation through Michigan Medicine’s Department of Psychiatry and discuss it with your provider.
FEATURED RESEARCH PROJECT
Standard prenatal care focuses on the physical health of the mom and baby. However, women come into clinics with diverse psychosocial needs. To address these needs, a community-based research project is creating an integrated Infant Mental Health (I-IMH) model by embedding IMH trained Behavioral Health Consultants (BHCs) in perinatal clinics. This collaboration with Starfish Family Services’ IMH program seeks to evaluate an innovative model of perinatal care that integrates support for women’s psychosocial, emotional, relational, economic, and mental health needs within perinatal clinics.
The I-IMH model provides mental health screenings, brief interventions, psycho-education, referrals and resources on-site at the OB/GYN clinic with a safe, soft, “one visit, one location” philosophy. Patients can meet with this embedded social worker, BHC, for up to five follow-up visits at the OB/GYN clinic to increase engagement into mental health services. If appropriate, a patient can access additional support in the form of a referral to IMH-HV services that can be delivered by the same clinician who offers in-office services, or by warm referrals to community clinicians.
A recent survey of providers and staff included positive feedback for the model thus far:
“The presence of a Behavioral Health Consultant in our office has been a welcome and necessary addition to our practice model. I only wish we had a full-time consultant in the office, we would certainly keep them busy. In a world where we, as medical providers, are expected to see more patients in a smaller amount of time, and in a world where mental health issues are becoming more and more prevalent, a BHC takes on a large amount of the onus on referring and counseling. [The BHCs] in our office have been invaluable!”
NURSE PRACTITIONER, 23 YEARS
The I-IMH project strives to establish an evidence base for a treatment program that provides services to many of Michigan’s most vulnerable individuals. This program proposes a sustainable intervention aiming to increase access to care for these high risk women and their children in the following ways:
This evaluation focuses on early intervention and aims to compare costs and benefits of implementing the I-IMH model, at both the individual and system levels. As this I-IMH model supports Medicaid mothers, infants, and families during fetal and early stages in child development, it bears the potential to be preventive, ameliorating serious mental health issues at later developmental stages. Thus this project may also alleviate personal and societal burdens longer term.
Perinatal Psychiatry Clinic team members are experts in reproductive mental health and come from many disciplines, including psychiatry, nursing, psychology and social work. They focus on making comprehensive evaluations available to women in a time-sensitive manner, and provide a broad range of evidence-based services including psychotherapy, complementary approaches, and safe medication management.
Clinical Associate Professor
PSYCHOLOGY POSTDOCTORAL FELLOW
SOCIAL WORK FELLOW
SOCIAL WORK INTERNS
Christopher Sanderson, Danielle Lantz Rohlfs, Samantha Schwartz
Annie Phan-Huy, Christopher Kline, Theresa Gattari, Spencer Gregerson, Dan Oram (Women’s Health Fellow)