Maternal Mental Health Month 2023: Adrienne Griffen
“Our vision is that all pregnant and postpartum people are educated about, screened for, and treated for mental health conditions. How we get there is through policy work. There are some days when I’m like, This is too big a problem. And then I think, You know what? Every mom who got help today was a mom who didn't get help yesterday. There is progress.”
Adrienne Griffen, MPP, is the Executive Director of the Maternal Mental Health Leadership Alliance, and an advocate and subject-matter expert in maternal mental health.
Prior to joining MMHLA, Adrienne founded Postpartum Support Virginia and served as executive director for 10 years, establishing a statewide network of peer-led support groups, creating educational programs for mental health providers and maternal-child healthcare professionals, and helping pass legislation requiring information about postpartum depression and anxiety be provided to new mothers.
Adrienne graduated from the United States Naval Academy and has a master’s in Public Policy from Harvard’s Kennedy School of Government. She and her family live in Arlington VA.
This blog is made possible by a sponsorship from Sage Therapeutics. All content on this page has been curated by the Mass. PPD Fund without input from Sage Therapeutics, Inc.
May 2023 | Interviewed and edited by Jessie Colbert, Executive Director, Mass. PPD Fund
For Maternal Mental Health Month, the Mass. PPD Fund is proud to feature survivor and trailblazing national MMH leader, Adrienne Griffen, Executive Director of the Maternal Mental Health Leadership Alliance (MMHLA). The MMHLA advocates for national policies that provide universal, equitable, comprehensive, and compassionate mental health care during pregnancy and the year following pregnancy.
We discussed Adrienne’s lived experience, as well as how the MMHLA came to be through a wonderful partnership between Adrienne and MMHLA Founder and former Massachusetts State Rep. Jamie Belsito — also a longtime friend and partner of the Fund. We talked about the MMHLA’s groundbreaking accomplishments, their larger vision, and how Adrienne stays motivated to do the vital but challenging work of moving forward federal policy on maternal mental health.
Your experience with postpartum mental health complications was with your second child. Can you share how you went into that experience? How had it gone with your first baby?
I have three children, who are 23, 21 and 18. My first child, my daughter, was an incredibly easy baby — super easy pregnancy, super easy labor and delivery, super easy baby. At three months, she was sleeping 12 hours a night and taking two three-hour naps. I recall this because she was born in September, and we had a Christmas party in early December. We had a dinner party for 40 people with a three-month-old! Because I knew she would sleep.
What happened with your second?
With our second child, it was a very, very different experience. I had a very scary emergency C-section, and my son probably would have died if we had not been in the hospital. I remember lying on the operating room table like, What the hell just happened here? This total out-of-body experience. In the early weeks, I kept thinking, if I had just gone through labor and delivery, maybe I would be okay. Maybe things got short-circuited. I felt like I could not get my head above water.
My second baby also needed me more than my first. He liked to be held all the time, and he wouldn't take a bottle, so I was only breastfeeding. I was up every two or three hours for what seemed like months on end. At about four weeks, I made a call to my obstetrician. I said, Uh, my C-section scar needs to be checked. But really, I was like, I'm not doing so well. And she said, Well, do you want Zoloft or Paxil? I remember thinking, Could we talk about why I might need this?
She gave me the card for behavioral health, and then it took me six months to get the help that I needed. I reached out over and over but kept hitting dead ends: support groups that were no longer meeting, people who wouldn’t call back, therapists who weren’t accepting new patients. I kept thinking, I have every resource available, it shouldn't be this hard! Navigating the mental health system– it’s this whole parallel universe. And the worst part about our system is that we wait until people are at their worst [point], and then they have to figure out how to climb up out of the hole.
It was during that dark time in my life when I thought, I have got to do something about this. If it’s this hard for me to find help, what about people who don't know something's wrong? What if they don't know how to navigate – or don’t have the energy or the wherewithal to navigate – this complex mental health system? That is when I became an advocate, during that first year after my son was born.
Can you share how you eventually got better, and how you started helping other moms?
Eventually, my husband found a psychiatrist who specialized in maternal mental health. She gave me the Edinburgh Postnatal Depression Scale, and I’m like, Yes, yes, yes, yes, yes! [checking the boxes] Got on medication, got some therapy, and, you know, found my way back to normal. But it really took a toll on my self-esteem, on my relationship with my husband, on just everything.
We eventually had a third child. And that was planned, and well-thought-out. We put a lot more resources in place so that I didn't suffer from anxiety and depression again. For example, I stayed on antidepressants the whole time I was pregnant and breastfeeding. And we recognized that sleep was super important for me, so my husband helped with feeding the baby at night. My mother came for a while, then my mother-in-law came for a while. We had people bringing us meals and providing childcare. Fortunately, I got through it much better the third time.
A friend connected me with a woman from her church, who was featured in the local newspaper because she ran a support group for new moms. She connected me with Postpartum Support International (PSI), and I became a volunteer in Virginia, answering phone calls and emails from moms and families. Then I started a support group at our local hospital, and I just wanted to do more. At the time PSI had a very limited budget – about $50 a year for their volunteers. So I was like, I'll start my own nonprofit! This was back before PSI had chapters, so I started the quote-unquote Virginia Chapter, and called it Postpartum Support Virginia. We had a warm line, we ran support groups, we did trainings for providers. We had a great staff of young moms, all of whom had lived experience.
[Note: Adrienne survived a cancer diagnosis after founding Postpartum Support Virginia, and resumed her advocacy several years later.]
How did the Maternal Mental Health Leadership Alliance (MMHLA) get started?
MMHLA was the brainchild of my dear friend Jamie Belsito, who also has lived experience with maternal mental health conditions and who earlier in her career had worked in Washington DC doing policy advocacy work. Jamie is from Massachusetts, where they have a terrific program called MCPAP for Moms, and she thought it would be great to get some funding so that other states could replicate the program. So she came down to DC in 2015 and met with some members of Congress and worked on legislation to provide federal grants to states. In order to help raise awareness about the legislation, she organized the first-ever national Maternal Mental Health Advocacy Day in 2016, bringing about a hundred advocates to Capitol Hill to educate members and their staffs about maternal mental health.
Jamie and I have this really funny story from that first year. We were supposed to meet in person with our Congresswoman from Virginia. And somehow that didn't happen. And so, we're standing in the hall with my little team of advocates talking with [the Rep.’s] young staffer. And then our Congresswoman walked past us into the office. And I'm like, Well, she's here – what if we just go in and talk to her? And we ended up having this meeting with this incredible team of advocates from Virginia, one of whom was the sister of a mother of three who had taken her life after having a miscarriage. And [the Rep.] was like, You don't need to say anymore. I'm signing on to the legislation right now. That was our home run. Jamie and I became really fast friends.
Jamie organized additional advocacy days in 2017 and 2018 to ensure that Congress provided funding for maternal mental health and to raise awareness around maternal mortality issues. She realized someone needed to keep a focus on national policy around maternal mental health, so she pulled together a group of people who had helped her with this legislation and decided to launch the Maternal Mental Health Leadership Alliance.
What have been the MMHLA’s accomplishments since that time?
We have been relatively successful in advocating for two very important programs. The first is the National Maternal Mental Health Hotline (1-833-TLC-MAMA or 1-833-852-6262). I remember when I first came to the MMHLA, I was going around meeting with different people and looking at things at the national level. And I thought, Oh my gosh, all these organizations, whether it's the Department of Health and Human Services, or the Mayo Clinic, or the CDC, they all list the signs and symptoms of postpartum depression. And [they say], If you need help, contact Postpartum Support International. And I thought, if the federal government is holding up PSI as the go-to organization, they ought to fund it in some way. And so I started advocating for funding for PSI to expand their helpline into a hotline where people can talk to somebody live 24/7. And here we are, a few years later, and PSI is managing the National Maternal Mental Health Hotline. We've gone back to Congress several times, and the Hotline is in federal legislation, so it is authorized and funded.
The other big program we advocate for is funding grants for psychiatry access programs. That was the first piece of legislation that Jamie led based on MCPAP for Moms. We advocated for that funding for the first five years. We just introduced a second piece of legislation, Into the Light for Maternal Mental Health, that reauthorizes and funds those programs at a greater level for the next five years.
That’s awesome. What would you say is your ultimate vision for the MMHLA, and for maternal mental health generally?
Our vision is that all pregnant and postpartum people are educated about, screened for, and treated for mental health conditions. How we get there is through the policy work. I think the greater vision for everybody in the field is that people are knowledgeable about these illnesses, they're screened, they're identified, and they have access to care, whatever that care looks like — whether it’s a support group, a therapist, one of the psychiatry access programs, or a hotline. MMHLA focuses on three strategic areas: advocating for change; building partnerships and convening people; and curating information. We really want we see ourselves as the go-to for anything you want to know about maternal mental health.
One challenge I see on our issue is integrating services into the health care system, since it falls between OB care and mental health care. Do you see any good ways to tackle this?
Let me tell you about a project we've been working on over the last year and a half or so, the Perinatal Mental Health Education and Screening Project. There are all these recommendations out there about screening moms, but they’re very siloed – ACOG [American College of Obstetricians and Gynecologists] says this, AAP [American Academy of Pediatrics] says that. We spent a year synthesizing them all together and came up with this framework, ideal points when pregnant and postpartum people should be educated about and screened for perinatal mental health conditions. But we also uncovered four specific barriers [to screening], which we are now working to address.
The first is updating screening tools. We heard over and over again that screening tools are out of date, and don’t necessarily ask the right questions, particularly for women of Color. So we have found a team of researchers who are very interested in developing an updated, refreshed, more inclusive, more robust screening tool.
We are also looking at education and reimbursement for providers to ensure they are knowledgeable about perinatal mental health disorders, and are adequately and easily reimbursed for providing patient education and screening. And finally, we are looking at identifying existing resources – and creating more as needed – to ensure that individuals impacted by these illnesses have access to care. There’s all of these big, big things that need to change. But we felt like starting with screening was sort of the wedge to make a lot of this change happen.
There’s so much work to do, and so much that needs to change. It can feel overwhelming. How do you stay encouraged and motivated as you do this work?
There are some days when I’m like, This is too big a problem. And then I think, You know what? Every mom who got help today was a mom who didn't get help yesterday. And there's so many people working in this field. When I started all of this, I was the only volunteer in Virginia, and now there's a whole nonprofit in Virginia, and they have support groups all over the state. And it's happening in so many other places. So, there is progress.