Maternal Mental Health: Where Should Our Research and Policy Priorities Be?

In the midst of the COVID-19 pandemic, mental health care has become an increasingly important topic in light of the cumulative stressors of social isolation, economic insecurity, anxiety and fears of infection, fi nancial hardship, and the potential loss of friends or family. Evidence suggests that mental health disorders, including major depression disorder (MDD) and anxiety disorders, are increasing at an alarming rate in the setting of the COVID-19 pandemic, and access to mental health care remains limited. During this critical time, maternal mental health deserves special attention by researchers and policy makers for several reasons, but particularly because of growing evidence that maternal mental health has long-reaching eff ects on the physical, intellectual, and emotional development of a woman’s children [1]. Maternal mental health is therefore a true public health issue that ultimately affects every one of us. Beyond this compelling reason to focus on maternal mental health, a number of other unique aspects to the mental health of women complicate treatment. For example, women are more likely to be the victims of physical and sexual abuse, and the ebb and fl ow of reproductive hormones can trigger mood and anxiety symptoms in biologically and socioeconomically vulnerable women. Furthermore, treating mental health disorders during the reproductive years requires a specialized knowledge of what medications can be used during pregnancy and lactation and a desperate need for research into best management practices for treatment during this critical time period. The COVID-19 pandemic, by increasing the mental health needs of both women and men, has only served to emphasize the knowledge gaps and need for policy change that will ultimately improve mental health outcomes for not only women, but men as well. On December 2, 2019, the Committee on Population of the National Academies of Sciences, Engineering, and Medicine held a stakeholder meeting on maternal mental health and women’s mental health across the life course. The meeting was meant to build and expand upon a previous workshop—Women’s Mental Health across the Life Course through a Sex and Gender Lens held in March 2018 [11]—with a new focus on maternal mental health. During the meeting, experts and stakeholders discussed maternal mental health and specifi cally focused on the perinatal period. The discussion addressed topics such as risk factors, barriers to mental health care, areas in need of research, and potential policy interventions. The authors of this commentary will present some of these ideas with the added perspective of a reproductive psychiatrist—a psychiatrist who specializes in the mental health care of women during the reproductive years. This commentary will also highlight opportunities brought on by the COVID-19 pandemic that have a bearing on these discussions.