In celebration of Maternal Mental Health (MMH) Awareness Month, the inaugural cohort of the Los Angeles County Maternal Mental Health Access (LAMMHA) program received its first training on April 13, 2023.
LAMMHA is a five-year program funded by The California Health Care Foundation (CHCF) to support Los Angeles County community health centers in the identification and treatment of common perinatal mental disorders in primary care. The project arose from increased urgency and interest in improving mental health treatment for patients in the perinatal period (which includes pregnancy and the first year postpartum).
Mood disorders such as depression and anxiety are among the most common medical conditions affecting perinatal patients, impacting around 1 in 3 birthing people in California and as many as 1 in 4 birthing people who identify as Black or Latina (MIHA 2018). In California, as well as nationally, maternal suicide is the leading cause of preventable maternal mortality (CA-PAMR 2019). Despite its known impact on maternal and child health and the existence of effective treatments, few birthing people receive appropriate screening and care for depression in the perinatal period, with access to care even more limited among traditionally under resourced populations. In the hustle and bustle of an already overburdened health care system, basic protocols for identification and treatment are not always followed, and the implementation of team-based models of care that are known to improve outcomes is limited.
To address this incredible need, the LAMMHA program offers two levels of support to improve perinatal mental health care, a yearly ECHO series and a Collaborative Care Model (CoCM) implementation learning collaborative.
The ECHO (Extension for Community Healthcare Outcomes) model uses a virtual educational lecture series and patient case discussion to improve provider preparedness to treat patients and improve patient outcomes. The LAMMHA ECHO Perinatal Case Conference Series will use the ECHO model to improve providers’ capacity to care for their patients’ mental health, aimed to improve patient identification and decrease suicide rates.
The CoCM is an evidence-based, integrated behavioral health intervention designed to support the treatment of common mental health conditions like depression in primary care settings. CoCM works with a patient’s existing medical providers and behavioral health professionals in the primary care setting and adds a psychiatric consultant (usually a psychiatrist or a psychiatric nurse practitioner) to support the patient and other care team members with medication management recommendations, psychoeducation, and other aspects of the patient’s mental health care.
Two health centers, AltaMed Health Services and Eisner Health, were selected to receive 2 years of intensive implementation support for the CoCM as part of the program. Sites participating in the learning collaborative program will receive $75,000 to implement the Collaborative Care model, as well as regular training on the identification and treatment of common mental health disorders seen among pregnant and postpartum patients. Training attendees include behavioral healthcare managers, psychiatric consultants, medical providers, and other staff.
The LAMMHA initiative is a collaboration between Community Clinic Association of Los Angeles County (CCALAC), Elevation Health Partners (EHP), Maternal Mental Health Now (MMHN), Concert Health, University of Pennsylvania (UPenn), University of California, Los Angeles (UCLA) and the Department of Psychiatry and Behavioral Sciences at the University of Washington.
For more information and/or to apply for a CoCM implementation CoCM and ECHO sessions, please visit the CCALAC LAMMHA program page. For more information and resources around maternal mental health in California, please visit the California Department of Public Health – Maternal Mental Health page.