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Managing America: Health

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Week Ending October 19, 2007

H.R.20 To provide for research on, and services for individuals with, postpartum depression and psychosis.

The bill, entitled the Melanie Blocker-Stokes Postpartum Depression Research and Care Act, aims to expand and identify research and related activities at the National Institute of mental Health with respect to postpartum depression and psychosis.

The affliction impacts 400,000 women after child birth each year. 80% suffer the mild form known as ‘baby blues’ that brings over-emotion, mood changes, poor sleep and other mild symptoms. Symptoms of the more progressed versions range from anxiety and mood disorders to losing touch with reality, delusions, hallucinations and other very serious symptoms that can lead to child abuse, neglect or the death of an infant.

The Director of the NIMH will coordinate with other national research institutes to expand the understanding of the causes of and to find a cure. The research will include basic research on the etiology and causes of the condition, epidemiological studies to address the frequency and natural history of the conditions and differences between racial and ethnic groups., development of diagnostic techniques, research for the development and evaluation of new treatments, and educational programs to inform the public.

The Secretary of Health and Human Services will make grants available for the ‘establishment, operation, and coordination of effective and cost-effective systems for the delivery of essential services to individuals with postpartum depression’ or psychosis.

Grant recipients must be a public or non-profit private entity to include a State or local government, public or non-profit private hospital, community-based organization, hospice, ambulatory care facility, community health center, migrant health center, homeless health center or other appropriate public or non-profit private entity.

Not more than 5% of the grant will be used for administration, accounting, reporting and program oversight, the funds will supplement, not supplant other funds, the applicant will abide by an limitations deemed appropriate by the Secretary on any charges to individuals receiving services pursuant to the grant that may be based on the financial circumstances of the individual receiving the services.

The Secretary will looks authorize projects that deliver or enhance outpatient and home-based health and support services, case management, screening and treatment, delivering or enhancing inpatient care management to ensure the wellbeing of the mother and family and the infant’s future development, and improve the quality, availability and organization of health care and support services such as transportation, attendant care, homemaker services, day and respite care and counseling for financial aid and insurance.

Sponsor:  Rep. Bobby Rush (D-IL-1^st)

Vote: Passed House 328 to 3 RC 963 October 15, 2007

Cost to the taxpayers: There are authorized to be appropriated such sums as may be necessary for each fiscal year 2008 through 2010. “CBO estimates that

implementing the bill would cost less than $500,000 in 2008 and $18 million over the

2008-2012 period, assuming the appropriation of the authorized amounts.”

Earmark Certification:  Not applicable to this bill.

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MORE INFORMATION

The Congress finds as follows:

(1) Postpartum depression is a devastating mood disorder which strikes many women during and after pregnancy.

(2) Postpartum mood changes are common and can be broken into three subgroups: `baby blues,' which is an extremely common and the less severe form of postpartum depression; postpartum mood and anxiety disorders, which are more severe than baby blues and can occur during pregnancy and anytime within the first year of the infant's birth; and postpartum psychosis, which is the most extreme form of postpartum depression and can occur during pregnancy and up to twelve months after delivery.

(3) `Baby blues' is characterized by mood swings, feelings of being overwhelmed, tearfulness, irritability, poor sleep, mood changes, and a sense of vulnerability.

(4) The symptoms of postpartum mood and anxiety disorders are the worsening and the continuation of the baby blues beyond the first days or weeks after delivery.

(5) The symptoms of postpartum psychosis include losing touch with reality, distorted thinking, delusions, auditory hallucinations, paranoia, hyperactivity, and rapid speech or mania.

(6) Each year over 400,000 women suffer from postpartum mood changes, with baby blues afflicting up to 80 percent of new mothers; postpartum mood and anxiety disorders impairing around 10-20 percent of new mothers; and postpartum psychosis striking 1 in 1,000 new mothers.

(7) The causes of postpartum depression are complex and unknown at this time; however, theories include a steep and rapid drop in hormone levels after childbirth; difficulty during labor or pregnancy; a premature birth; a miscarriage; feeling overwhelmed, uncertain, frustrated or anxious about one's new role as a mother; a lack of support from one's spouse, friends or family; marital strife; stressful events in life such as death of a loved one, financial problems, or physical or mental abuse; a family history of depression or mood disorders; a previous history of major depression or anxiety; or a prior postpartum depression.

(8) Postpartum depression is a treatable disorder if promptly diagnosed by a trained provider and attended to with a personalized regimen of care including social support, therapy, medication, and when necessary hospitalization.

(9) All too often postpartum depression goes undiagnosed or untreated due to the social stigma surrounding depression and mental illness, the myth of motherhood, the new mother's inability to self-diagnose her condition, the new mother's shame or embarrassment over discussing her depression so near to the birth of her child, the lack of understanding in society and the medical community of the complexity of postpartum depression, and economic pressures placed on hospitals and providers.

(10) Untreated, postpartum depression can lead to further depression, substance abuse, loss of employment, divorce and further social alienation, self-destructive behavior, or even suicide.

(11) Untreated, postpartum depression impacts society through its affect on the infant's physical and psychological development, child abuse, neglect or death of the infant or other siblings, and the disruption of the family.

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