Mississippi Today
Federal panel prescribes new mental health strategy to curb maternal deaths
For help, call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262) or contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.” Spanish-language services are also available.
BRIDGEPORT, Conn. — Milagros Aquino was trying to find a new place to live and had been struggling to get used to new foods after she moved to Bridgeport from Peru with her husband and young son in 2023.
When Aquino, now 31, got pregnant in May 2023, “instantly everything got so much worse than before,” she said. “I was so sad and lying in bed all day. I was really lost and just surviving.”
Aquino has lots of company.
Perinatal depression affects as many as 20% of women in the United States during pregnancy, the postpartum period, or both, according to studies. In some states, anxiety or depression afflicts nearly a quarter of new mothers or pregnant women.
Many women in the U.S. go untreated because there is no widely deployed system to screen for mental illness in mothers, despite widespread recommendations to do so. Experts say the lack of screening has driven higher rates of mental illness, suicide, and drug overdoses that are now the leading causes of death in the first year after a woman gives birth.
“This is a systemic issue, a medical issue, and a human rights issue,” said Lindsay R. Standeven, a perinatal psychiatrist and the clinical and education director of the Johns Hopkins Reproductive Mental Health Center.
Standeven said the root causes of the problem include racial and socioeconomic disparities in maternal care and a lack of support systems for new mothers. She also pointed a finger at a shortage of mental health professionals, insufficient maternal mental health training for providers, and insufficient reimbursement for mental health services. Finally, Standeven said, the problem is exacerbated by the absence of national maternity leave policies, and the access to weapons.
Those factors helped drive a 105% increase in postpartum depression from 2010 to 2021, according to the American Journal of Obstetrics & Gynecology.
For Aquino, it wasn’t until the last weeks of her pregnancy, when she signed up for acupuncture to relieve her stress, that a social worker helped her get care through the Emme Coalition, which connects girls and women with financial help, mental health counseling services, and other resources.
Mothers diagnosed with perinatal depression or anxiety during or after pregnancy are at about three times the risk of suicidal behavior and six times the risk of suicide compared with mothers without a mood disorder, according to recent U.S. and international studies in JAMA Network Open and The BMJ.
The toll of the maternal mental health crisis is particularly acute in rural communities that have become maternity care deserts, as small hospitals close their labor and delivery units because of plummeting birth rates, or because of financial or staffing issues.
This week, the Maternal Mental Health Task Force — co-led by the Office on Women’s Health and the Substance Abuse and Mental Health Services Administration and formed in September to respond to the problem — recommended creating maternity care centers that could serve as hubs of integrated care and birthing facilities by building upon the services and personnel already in communities.
The task force will soon determine what portions of the plan will require congressional action and funding to implement and what will be “low-hanging fruit,” said Joy Burkhard, a member of the task force and the executive director of the nonprofit Policy Center for Maternal Mental Health.
Burkhard said equitable access to care is essential. The task force recommended that federal officials identify areas where maternity centers should be placed based on data identifying the underserved. “Rural America,” she said, “is first and foremost.”
There are shortages of care in “unlikely areas,” including Los Angeles County, where some maternity wards have recently closed, said Burkhard. Urban areas that are underserved would also be eligible to get the new centers.
“All that mothers are asking for is maternity care that makes sense. Right now, none of that exists,” she said.
Several pilot programs are designed to help struggling mothers by training and equipping midwives and doulas, people who provide guidance and support to the mothers of newborns.
In Montana, rates of maternal depression before, during, and after pregnancy are higher than the national average. From 2017 to 2020, approximately 15% of mothers experienced postpartum depression and 27% experienced perinatal depression, according to the Montana Pregnancy Risk Assessment Monitoring System. The state had the sixth-highest maternal mortality rate in the country in 2019, when it received a federal grant to begin training doulas.
To date, the program has trained 108 doulas, many of whom are Native American. Native Americans make up 6.6% of Montana’s population. Indigenous people, particularly those in rural areas, have twice the national rate of severe maternal morbidity and mortality compared with white women, according to a study in Obstetrics and Gynecology.
Stephanie Fitch, grant manager at Montana Obstetrics & Maternal Support at Billings Clinic, said training doulas “has the potential to counter systemic barriers that disproportionately impact our tribal communities and improve overall community health.”
Twelve states and Washington, D.C., have Medicaid coverage for doula care, according to the National Health Law Program. They are California, Florida, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, Oklahoma, Oregon, Rhode Island, and Virginia. Medicaid pays for about 41% of births in the U.S., according to the Centers for Disease Control and Prevention.
Jacqueline Carrizo, a doula assigned to Aquino through the Emme Coalition, played an important role in Aquino’s recovery. Aquino said she couldn’t have imagined going through such a “dark time alone.” With Carrizo’s support, “I could make it,” she said.
Genetic and environmental factors, or a past mental health disorder, can increase the risk of depression or anxiety during pregnancy. But mood disorders can happen to anyone.
Teresa Martinez, 30, of Price, Utah, had struggled with anxiety and infertility for years before she conceived her first child. The joy and relief of giving birth to her son in 2012 were short-lived.
Without warning, “a dark cloud came over me,” she said.
Martinez was afraid to tell her husband. “As a woman, you feel so much pressure and you don’t want that stigma of not being a good mom,” she said.
In recent years, programs around the country have started to help doctors recognize mothers’ mood disorders and learn how to help them before any harm is done.
One of the most successful is the Massachusetts Child Psychiatry Access Program for Moms, which began a decade ago and has since spread to 29 states. The program, supported by federal and state funding, provides tools and training for physicians and other providers to screen and identify disorders, triage patients, and offer treatment options.
But the expansion of maternal mental health programs is taking place amid sparse resources in much of rural America. Many programs across the country have run out of money.
The federal task force proposed that Congress fund and create consultation programs similar to the one in Massachusetts, but not to replace the ones already in place, said Burkhard.
In April, Missouri became the latest state to adopt the Massachusetts model. Women on Medicaid in Missouri are 10 times as likely to die within one year of pregnancy as those with private insurance. From 2018 through 2020, an average of 70 Missouri women died each year while pregnant or within one year of giving birth, according to state government statistics.
Wendy Ell, executive director of the Maternal Health Access Project in Missouri, called her service a “lifesaving resource” that is free and easy to access for any health care provider in the state who sees patients in the perinatal period.
About 50 health care providers have signed up for Ell’s program since it began. Within 30 minutes of a request, the providers can consult over the phone with one of three perinatal psychiatrists. But while the doctors can get help from the psychiatrists, mental health resources for patients are not as readily available.
The task force called for federal funding to train more mental health providers and place them in high-need areas like Missouri. The task force also recommended training and certifying a more diverse workforce of community mental health workers, patient navigators, doulas, and peer support specialists in areas where they are most needed.
A new voluntary curriculum in reproductive psychiatry is designed to help psychiatry residents, fellows, and mental health practitioners who may have little or no training or education about the management of psychiatric illness in the perinatal period. A small study found that the curriculum significantly improved psychiatrists’ ability to treat perinatal women with mental illness, said Standeven, who contributed to the training program and is one of the study’s authors.
Nancy Byatt, a perinatal psychiatrist at the University of Massachusetts Chan School of Medicine who led the launch of the Massachusetts Child Psychiatry Access Program for Moms in 2014, said there is still a lot of work to do.
“I think that the most important thing is that we have made a lot of progress and, in that sense, I am kind of hopeful,” Byatt said.
Cheryl Platzman Weinstock’s reporting is supported by a grant from the National Institute for Health Care Management Foundation. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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Mississippi Today
Hospitals see danger in Medicaid spending cuts
Mississippi hospitals could lose up to $1 billion over the next decade under the sweeping, multitrillion-dollar tax and policy bill President Donald Trump signed into law last week, according to leaders at the Mississippi Hospital Association.
The leaders say the cuts could force some already-struggling rural hospitals to reduce services or close their doors.
The law includes the largest reduction in federal health and social safety net programs in history. It passed 218-214, with all Democrats voting against the measure and all but five Republicans voting for it.
In the short term, these cuts will make health care less accessible to poor Mississippians by making the eligibility requirements for Medicaid insurance stiffer, likely increasing people’s medical debt.
In the long run, the cuts could lead to worsening chronic health conditions such as diabetes and obesity for which Mississippi already leads the nation, and making private insurance more expensive for many people, experts say.
“We’ve got about a billion dollars that are potentially hanging in the balance over the next 10 years,” Mississippi Hospital Association President Richard Roberson said Wednesday during a panel discussion at his organization’s headquarters.
“If folks were being honest, the entire system depends on those rural hospitals,” he said.
Mississippi’s uninsured population could increase by 160,000 people as a combined result of the new law and the expiration of Biden-era enhanced subsidies that made marketplace insurance affordable – and which Trump is not expected to renew – according to KFF, a health policy research group.
That could make things even worse for those who are left on the marketplace plans.
“Younger, healthier people are going to leave the risk pool, and that’s going to mean it’s more expensive to insure the patients that remain,” said Lucy Dagneau, senior director of state and local campaigns at the American Cancer Society.
Among the biggest changes facing Medicaid-eligible patients are stiffer eligibility requirements, including proof of work. The new law requires able-bodied adults ages 19 to 64 to work, do community service or attend an educational program at least 80 hours a month to qualify for, or keep, Medicaid coverage and federal food aid.
Opponents say qualified recipients could be stripped of benefits if they lose a job or fail to complete paperwork attesting to their time commitment.
Georgia became the case study for work requirements with a program called Pathways to Coverage, which was touted as a conservative alternative to Medicaid expansion.
Ironically, the 54-year-old mechanic chosen by Georgia Gov. Brian Kemp to be the face of the program got so fed up with the work requirements he went from praising the program on television to saying “I’m done with it” after his benefits were allegedly cancelled twice due to red tape.
Roberson sent several letters to Mississippi’s congressional members in weeks leading up to the final vote on the sweeping federal legislation, sounding the alarm on what it would mean for hospitals and patients.
Among Roberson’s chief concerns is a change in the mechanism called state directed payments, which allows states to beef up Medicaid reimbursement rates – typically the lowest among insurance payors. The new law will reduce those enhanced rates to nearly as low as the Medicare rate, costing the state at least $500 million and putting rural hospitals in a bind, Roberson told Mississippi Today.
That change will happen over 10 years starting in 2028. That, in conjunction with the new law’s one-time payment program called the Rural Health Care Fund, means if the next few years look normal, it doesn’t mean Mississippi is safe, stakeholders warn.
“We’re going to have a sort of deceiving situation in Mississippi where we look a little flush with cash with the rural fund and the state directed payments in 2027 and 2028, and then all of a sudden our state directed payments start going down and that fund ends and then we’re going to start dipping,” said Leah Rupp Smith, vice president for policy and advocacy at the Mississippi Hospital Association.
Even with that buffer time, immediate changes are on the horizon for health care in Mississippi because of fear and uncertainty around ever-changing rules.
“Hospitals can’t budget when we have these one-off programs that start and stop and the rules change – and there’s a cost to administering a program like this,” Smith said.
Since hospitals are major employers – and they also provide a sense of safety for incoming businesses – their closure, especially in rural areas, affects not just patients but local economies and communities.
U.S. Rep. Bennie Thompson is the only Democrat in Mississippi’s congressional delegation. He voted against the bill, while the state’s two Republican senators and three Republican House members voted for it. Thompson said in a statement that the new law does not bode well for the Delta, one of the poorest regions in the U.S.
“For my district, this means closed hospitals, nursing homes, families struggling to afford groceries, and educational opportunities deferred,” Thompson said. “Republicans’ priorities are very simple: tax cuts for (the) wealthy and nothing for the people who make this country work.”
While still colloquially referred to as the One Big Beautiful Bill Act, the name was changed by Democrats invoking a maneuver that has been used by lawmakers in both chambers to oppose a bill on principle.
“Democrats are forcing Republicans to delete their farcical bill name,” Senate Democratic Leader Charles Schumer of New York said in a statement. “Nothing about this bill is beautiful — it’s a betrayal to American families and it’s undeserving of such a stupid name.”
The law is expected to add at least $3.3 trillion to the nation’s debt over the next 10 years, according to the most recent estimate from the Congressional Budget Office.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Hospitals see danger in Medicaid spending cuts appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
This article reports on the negative impacts of a major federal tax and policy bill on Medicaid funding and rural hospitals in Mississippi. While it presents factual details and statements from stakeholders, the tone and framing emphasize the harmful consequences for vulnerable populations and health care access, aligning with concerns typically raised by center-left perspectives. The article highlights opposition by Democrats and critiques the bill’s priorities, particularly its effect on poor and rural communities, suggesting sympathy toward social safety net preservation. However, it maintains mostly factual reporting without overt partisan language, resulting in a moderate center-left bias.
Crooked Letter Sports Podcast
Podcast: The Mississippi Sports Hall of Fame Class of ’25
The MSHOF will induct eight new members on Aug 2. Rick Cleveland has covered them all and he and son Tyler talk about what makes them all special.
Stream all episodes here.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
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Mississippi Today
‘You’re not going to be able to do that anymore’: Jackson police chief visits food kitchen to discuss new public sleeping, panhandling laws
Diners turned watchful eyes to the stage as Jackson Police Chief Joseph Wade took to the podium. He visited Stewpot Community Services during its daily free lunch hour Thursday to discuss new state laws, which took effect two days earlier, targeting Mississippians experiencing homelessness.
“I understand that you are going through some hard times right now. That’s why I’m here,” Wade said to the crowd. “I felt it was important to come out here and speak with you directly.”
Wade laid out the three bills that passed earlier this year: House Bill 1197, the “Safe Solicitation Act,” HB 1200, the “Real Property Owners Protection Act” and HB 1203, a bill that prohibits camping on public property.
“Sleeping and laying in public places, you’re not going to be able to do that anymore,” he said. “There’s a law that has been passed that you can’t just set up encampments on public or private properties where it’s a public nuisance, it’s a problem.”
The “Real Property Owners Protection Act,” authored by Rep. Brent Powell, R-Brandon, is a bill that expedites the process of removing squatters. The “Safe Solicitation Act,” authored by Rep. Shanda Yates, I-Jackson, requires a permit for panhandling and allows people to be charged with a misdemeanor if they violate this law. The offense is punishable by a fine not to exceed $300 and an offender could face up to six months in jail. Wade said he’s currently working with his legal department to determine the best strategy for creating and issuing permits.
“We’re going to navigate these legal challenges, get some interpretations, not only from our legal department, but the Attorney General’s office to ensure that we are doing it legally and lawfully, because I understand that these are citizens,” he said. “I understand that they deserve to be treated with respect, and I understand that we are going to do this without violating their constitutional rights.”
Wade said the Jackson Police Department is steadily fielding reports of squatters in abandoned properties and the law change gives officers new power to remove them more quickly. The added challenge? Figuring out what to do with a person’s belongings.
“These people are carrying around what they own, but we are not a repository for all of their stuff,” he said. “So, when we make that arrest, we’ve got to have a strategic plan as to what we do with their stuff.”
Wade said there needs to be a deeper conversation around the issues that lead someone to becoming homeless.
“A lot of people that we’re running across that are homeless are also suffering from medical conditions, mental health issues, and they’re also suffering from drug addiction and substance abuse. We’ve got to have a strategic approach, but we also can’t log jam our jail down in Raymond,” Wade said.
He estimates that more than 800 people are currently incarcerated at the Raymond Detention Center, and any increase could strain the system as the laws continue to be enforced.
“I think there’s layers that we have to work through, there’s hurdles that we are going to overcome, but we’ve got to make sure that we do it and make sure that my team and JPD is consistent in how we enforce these laws,” Wade said.
Diners applauded Wade after he spoke, in between bites of fried chicken, salad, corn and 4th of July-themed packaged cakes. Wade offered to answer questions, but no one asked any.
Rev. Jill Buckley, executive director of Stewpot, said that the legislation is a good tool to address issues around homelessness and community needs. She doesn’t want to see people who are homeless be criminalized, but she also wants communities to be safe.
“I support people’s right to self determine, and we can’t impose our choices on other people, but there are some cases in which that impinges on community safety, and so to the extent that anyone who is camping or panhandling or squatting and is a danger to themselves and others, of course, I fully support that kind of law. I don’t support homelessness being criminalized as such,” Buckley said.
Many of the people Wade addressed while they ate Thursday said they have housing, don’t panhandle, and shouldn’t be directly impacted by the legislation. But Marcus Willis, 42, said it would make more sense if elected officials wanted to combat the negative impacts of homelessness that they help more people secure employment.
“There ain’t enough jobs,” said Willis, who was having lunch with his girlfriend Amber Ivy.
The two live in an apartment together nearby on Capitol Street, where Ivy landed after her mother, whom Ivy had been living with, suffered a stroke and lost the property. Similarly, Willis started coming to eat at Stewpot after his grandmother, whose house he used to visit for lunch, passed away.
Willis holds odd jobs – cutting grass, home and auto repair – so the income is inconsistent, and every opportunity for stable employment he said he’s found is outside of Jackson in the suburbs. The couple doesn’t have a car.
Making rent every month usually depends on their ability to find someone to help chip in, said Ivy, who is in recovery from substance abuse. She said she’s watched problems surrounding homelessness grow over the years in Jackson. Ivy grew up near Stewpot and has lived in various neighborhoods across the city – except for the times she moved out of state when things got too rough.
“There was just moments where I just had to leave,” Ivy said. “Sometimes if you hit a slump here, there’s almost no way for you to get out of it.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post 'You're not going to be able to do that anymore': Jackson police chief visits food kitchen to discuss new public sleeping, panhandling laws appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Right
This article primarily reports on new laws in Jackson, Mississippi, targeting public sleeping, panhandling, and squatting, focusing on statements by Police Chief Joseph Wade and community perspectives. The coverage presents the legislative measures—authored by Republican and independent lawmakers—with a tone that emphasizes law enforcement challenges and community safety, reflecting a conservative approach to homelessness as a public order issue. While it includes voices concerned about criminalization and the need for social support, the overall framing centers on law enforcement and property protection. The article maintains factual reporting without overt editorializing but leans slightly toward a center-right perspective by highlighting legal enforcement as a solution.
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