Perinatal Mental Health

Providing services tailored to people who are pregnant and parenting

Seven years ago, Duffy Health Center was approached by Cape Cod Healthcare about partnership on a program called Moms Do Care, given our team’s expertise in treating addiction and supporting pathways to recovery. Funded by the Massachusetts Department of Public Health, Bureau of Substance Addiction Services, the goal of the statewide program is to provide multidisciplinary, peer-led, recovery oriented, wrap around support for pregnant, postpartum, and parenting women with a history of substance use. Eligible women are those who are pregnant or parenting a child 3 or younger, who are concerned about their current or past experiences with substances. (healthrecovery.org/ page/moms-do-care)

The Duffy team gladly accepted the invitation to collaborate, as we tend to do when presented with the opportunity to be involved with an innovative new program. Since its inception, Moms Do Care has come fully under Duffy’s management. The team includes a Certified Addiction Registered Nurse, a Licensed Clinical Social Worker, and two Recovery Coaches with lived experience (pictured at right).

The Moms Do Care program is overseen by Daniel Rodrigues, LICSW, PMH-C, Duffy Health Center’s Director of Substance Use Disorder and Outreach Programs. With a background in maternal health and mental health, Danny has been an advocate for the women served by Moms Do Care and for the Duffy team members who run it, ensuring that they are trained to provide support to participants at any level they may need it.

Recognizing Needs

As Moms Do Care has evolved over the years, and in working closely with the individuals engaged in the program, the team began to notice that they seemed highly susceptible to perinatal mood and anxiety disorders (PMAD). Left untreated, these mental health challenges can evolve into crises, and they’re not uncommon during pregnancy and the first year postpartum and beyond.

As Danny shares, “There’s a lack of perinatal mental health support for the general public, let alone women who also have a history of substance use. Most support - including our program, for a time - is focused on the history of substance use, but not enough on the vulnerability to perinatal anxiety or mood disorders, which are unique unto themselves.”

After becoming certified in Perinatal Mental Health himself, Danny wanted to provide his team with the tools to support the women in our care through this pivotal time in their lives.

Bringing Expertise to Our Patients

In 2019, the Moms Do Care team attended a 2-day conference through Postpartum Support International (PSI) to learn more about perinatal mental health, how to identify it, and how to help clients distinguish between the “baby blues” and something more. Once the team became informed, the next hurdle was where to send them for clinical support.

Immediately, Amanda McGerigle, LISCW, PMH-C, Embedded Therapist on Duffy’s team for Office Based Addiction Treatment (OBAT), stepped forward with interest to acquire the certificate. “It’s important at Duffy that a qualified person is available to address whatever needs our patients have,” says Amanda. “Given where I sit on the OBAT team, I’ve seen that substance use is a risk factor for anxiety and mood disorders for people who are pregnant and for years after.”

As Amanda notes, the population that we work with is often managing so much - trauma, mental health, substance use disorder - so layering in new parenthood can compound existing vulnerabilities. There is value in having Duffy clinicians who know them at their baseline and can recognize a change in patterns. “We do really well at building relationships with our patients, so we’ve created a space where they feel safe sharing thoughts and feelings that are associated with their pregnancy or in the postpartum timeframe that they may be scared to share elsewhere,” says Amanda.

Community Engagement

As has become increasingly apparent, there is a serious lack of resources for women dealing with perinatal mental health disorders. Over time, the Duffy team recognized the opportunity to offer support to the general public. Mariel Bitter, LICSW, PMH-C, was hired as the therapist for Moms Do Care, tasked with creating additional programming for participants. Mariel became Perinatal Mental Health certified, and has created a free, public PMAD support group, offering the opportunity for people who haven’t asked for help before to come to a neutral location and learn more about available services before fully engaging. The group is offered weekly in Falmouth, Dennis, and at Cape Cod Hospital.

“Although I’m not a parent myself, I grew up with a mom who suffered from severe mental health issues so I have a deep understanding of how PMADs can impact the entire family unit,” shares Mariel. “I love working with the moms and seeing the love they share with their children.”

Mariel is not only facilitating these groups through her role at Duffy, she also serves on the Cape and Islands Maternal Depression Taskforce and as the PSI Regional Support Coordinator for Plymouth and Barnstable counties, providing for referrals and resources on behalf of PSI. Mariel has a vast knowledge of available resources and can refer women to those that are appropriate for their needs.

To learn more about Duffy Health Center’s PMAD support groups, visit the events section on our Facebook page.

To learn more about perinatal mental health, visit Postpartum Support International’s website: www. postpartum.net