2023 Regular Session ENROLLED SENATE RESOLUTION NO. 136 BY SENATOR BOUDREAUX A RESOLUTION To urge and request the Louisiana Department of Health to assist in the development of a public service campaign to foster awareness and education on perinatal mental health care. WHEREAS, more women die in the United States from complications of pregnancy and childbirth than in any other developed country in the world, with an average of three women dying each day in 2021; and WHEREAS, according to a 2023 report from the Centers for Disease Control and Prevention, the number of women in the United States dying from maternal causes almost doubled between 2018 and 2021, from six hundred fifty-eight deaths in 2018 to over one thousand two hundred deaths in 2021; and WHEREAS, black women in the United States are disproportionately impacted by complications from pregnancy and childbirth, being more than two and a half times more likely to die from complications of pregnancy and childbirth in 2021 as compared to white women; and WHEREAS, mental health problems are the most common complication of pregnancy, affecting up to one in five women in the perinatal period, and as many as two in five women who are low income or persons of color; and WHEREAS, in 2021, mental health-related conditions, namely suicide and overdose, were the leading cause of pregnancy-related deaths in the United States; and WHEREAS, according to the 2017-19 Louisiana Pregnancy-Associated Mortality Review Report released in August 2022, the overall leading cause of pregnancy-associated deaths was accidental overdose, accounting for seventeen percent of the deaths that occurred during pregnancy or within one year of the end of the pregnancy; and WHEREAS, mental health and substance use disorders during pregnancy and in the postpartum period often go unidentified and studies suggest that less than fifty percent of women with perinatal mental health problems are identified by their frontline physician; and Page 1 of 4 SR NO. 136 ENROLLED WHEREAS, women identified as experiencing perinatal mental health symptoms often do not receive treatment, with as many as seventy-five percent of women experiencing perinatal mental health symptoms going untreated; and WHEREAS, despite the prevalence and risks, there is a lack of awareness of perinatal mental health and substance use disorders among family members, the public, and providers, and many mothers feel reluctant to report symptoms and concerns; and WHEREAS, stigma has been seen as one of the leading barriers to accessing care and, as a result of stigma, fewer individuals seek treatment; and WHEREAS, the mental health of women before, during, and after childbirth is an issue of great concern to those affected, their families, and their physicians; and WHEREAS, when left untreated, mental health and substance use disorders in pregnancy and postpartum period can have serious medical, societal, and economic consequences; and WHEREAS, children born to mothers with untreated mental health and substance use disorders are at increased risk for serious health, developmental, or behavioral conditions, which can affect their overall development and growth; and WHEREAS, mental health and substance use disorders in pregnancy and the postpartum period are treatable, and better treatment outcomes are realized with early identification and intervention; and WHEREAS, all of Louisiana has been designated as a mental health professional shortage area by the federal Human Resources and Services Administration and there is a scarcity of mental health professionals available in Louisiana, especially psychiatrists, to treat perinatal mental health and substance use disorders; and WHEREAS, primary care providers and mental health professionals often lack training in addressing the mental health needs of pregnant and postpartum women; and WHEREAS, addressing perinatal mental health concerns has been identified as a critical need by the Louisiana Department of Health, the Louisiana Commission on Perinatal Care and the Prevention of Infant Mortality, the Louisiana Pregnancy-Associated Mortality Review, the Louisiana Pritzker Children's Initiative, and various other commissions, councils, and advisory boards in Louisiana; and Page 2 of 4 SR NO. 136 ENROLLED WHEREAS, in its 2017-19 Louisiana Pregnancy-Associated Mortality Review Report, the Louisiana Pregnancy-Associated Mortality Review Committee identified the following areas in its list of priorities for prevention of pregnancy-related and pregnancy-associated deaths: improve care coordination before, during, and after pregnancy; improve and expand identification and treatment for substance use and mental health during pregnancy; and ensure pregnant women receive the appropriate level of care based on their medical issues and risk factors; and WHEREAS, the Louisiana Perinatal Mental Health Task Force, as enacted by House Concurrent Resolution No. 105 of the 2021 Louisiana Regular Legislative Session, recognized in its policy brief that while Louisiana has implemented key policy changes, program, and initiatives that have created forward momentum toward improving mental health outcomes for pregnant and postpartum women, more concerted policy and programmatic efforts are needed to sustain current efforts and to address system gaps and deep-rooted inequities in the healthcare structures; and WHEREAS, Louisiana has implemented key policy changes that positively impact pregnant and postpartum women, including the extension of postpartum Medicaid coverage for twelve months after delivery, Medicaid reimbursement for caregiver depression screenings conducted during well-child visits, and the passage of Act No. 188, the Perinatal Mood and Anxiety Disorders Act, in the 2022 Louisiana Regular Legislative Session, which provides for information sharing by hospitals and birthing centers, perinatal mood disorder screening, mental health treatment, and collaborative care; and WHEREAS, the Louisiana Perinatal Mental Health Task Force, as enacted by House Concurrent Resolution No. 105 in the 2021 Legislative Session, made the priority recommendation to expand mental health access for pregnant and postpartum women by promoting and investing long-term in a provider-to-provider mental health consultation and training program that builds the capacity of healthcare providers across the state to respond to the mental health needs of pregnant and postpartum women; and WHEREAS, the federal Health Resources and Services Administration recognized the need and opportunity for the development of a mental health access program in Louisiana and provided funding to Louisiana Department of Health, office of public health, Page 3 of 4 SR NO. 136 ENROLLED bureau of family health to develop a statewide provider-to-provider mental health consultation program that provides guidance, education, and care coordination support to perinatal and pediatric healthcare providers. THEREFORE, BE IT RESOLVED that the Senate of the Legislature of Louisiana does hereby urge and request the Louisiana Department of Health to assist in the development of a public service campaign to foster awareness and education on perinatal mental health care. BE IT FURTHER RESOLVED that the Senate of the Legislature of Louisiana does hereby encourage mental healthcare providers and healthcare providers who provide care to pregnant and postpartum women to attend continuing education courses on perinatal mental health care. BE IT FURTHER RESOLVED that the Senate of the Legislature of Louisiana does hereby express support for a statewide mental health consultation program that uses provider-to-provider consultation, education, and resource and referral support to enhance the capacity of frontline healthcare providers to identify, diagnose, treat, and refer pregnant and postpartum women with mental health or substance use concerns. BE IT FURTHER RESOLVED that the Senate of the Legislature of Louisiana does hereby urge and request the Louisiana Department of Health to identify and seek long-term, sustainable sources of funding for a statewide mental health consultation program. BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the Louisiana Department of Health. PRESIDENT OF THE SENATE Page 4 of 4