A Strategy To Support Perinatal Mental Health By Collaborating With Tribal Communities In Montana.

Among Indigenous women and birthing people, reported rates of perinatal mental health complications are consistently higher than in the general US population. However, perinatal mental health programs and interventions tend to focus on the general population and do not account for the unique experiences and worldviews of Indigenous Peoples. We highlight a collaborative strategy employed by a Montana nonprofit to engage Tribal communities in completing a statewide online resource guide designed to help pregnant and parenting families find resources, including mental health and substance use treatment options, within and beyond their local communities. Based on this strategy, cultural resources relevant to Tribal communities were added to the resource guide. Agencies committed to addressing perinatal mental health disparities among Indigenous populations should consider similar strategies to share power with Tribal communities and collaboratively create culturally congruent programs and interventions.

Reducing Fear to Help Build Healthy Families: Investing in Non-Punitive Approaches to Helping People with Substance Use Disorder.

BACKGROUND: Many pregnant and parenting people with substance use disorders (SUD) refrain from seeking perinatal care or treatment for their SUD for fear of being treated poorly by health care providers and/or triggering a child welfare investigation. For those who do seek treatment, there are relatively few clinicians willing and able to prescribe medications for opioid use disorder (MOUD) to pregnant people. Both stigma and lack of access to treatment put many pregnant and parenting people at risk. Drug-related deaths contribute significantly to U.S. maternal mortality rates, with people at especially high risk of drug overdose in the months following delivery. METHODS: The Foundation for Opioid Response Efforts (FORE) is a national philanthropy focused on finding and fostering solutions to the opioid crisis. We draw lessons from our grantees' efforts to expand access to substance use treatment and recovery supports for pregnant and parenting people. RESULTS: To build systems of care that ensure more pregnant people get timely perinatal care, we need to expand training for perinatal providers on how to provide OUD treatment, clarify child welfare reporting rules, and engage and support trusted organizations and community-based services. CONCLUSIONS: In addition to changes to our systems of SUD treatment and recovery, we need greater philanthropic investment in efforts to combat the public health crisis of substance use and overdose among pregnant and parenting people. Private funders have the leeway to act quickly, take risks, and demonstrate the effectiveness of new approaches, building the case for investment of public resources in such initiatives.

Use of Evidence-Based Technology to Assist the Behavioral Health Workforce: A Case Study on Technology Transfer Systems.

ABSTRACT: This article provides examples of the application of technology transfer to improve the delivery of addiction prevention, treatment, and recovery. The article describes a case example of two regional Technology Transfer Centers (TTCs) focused on addiction and mental health. It illustrates the importance of cross-regional and network-wide activities as well as meaningful collaborations with other regional networks, professional associations, and state and federal entities. This article describes a model of identifying and delivering meaningful training and technical assistance (T/TA), which also advances interprofessional collaborations and shared ownership. The described model includes collaboration in assessing behavioral health T/TA needs and preference for delivery of T/TA. The case study presents the process of engaging providers and connecting them with content experts on emerging topics in the field of addiction. This work included T/TA around integrated care, co-occurring disorders, cultural humility and inclusion, and use of data to advance system care. The case also outlines the application and use of evidence-based translation models, including Project ECHO (Extension for Community Healthcare Outcomes) and Communities of Practice.

Midwives Uniquely Suited to Deliver Woman-Centered Care and Decrease Stigma for Women With Substance Use Disorders.

Midwives are being called to serve a growing population of vulnerable women, those with substance use disorders (SUDs). Increasing numbers of women across the lifespan are being diagnosed with SUDs. In addition, women with SUDs are experiencing very unique and distinct differences in stigma related to their substance use. This stigma is coming from varied sources and through many different forms including mislabeling, misinformation, the media, and a devalued maternal/child relationship. Mothers frequently experience different types of adverse health encounters during the perinatal and postpartum period that also contribute to stigma. Midwives are positioned to provide woman-centered care in a variety of practice settings as integral members of interprofessional teams. Midwives can decrease the stigma women with SUDs are experiencing while improving the health of women, mothers, and families worldwide.

Screening Women for At-Risk Alcohol Use: An Introduction to Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Women's Health.

A significant number of women engage in at-risk drinking behavior, or heavy alcohol use. Women are especially at risk for the negative impact of excessive alcohol consumption secondary to gender differences in body structure, chemistry, and alcohol absorption. In addition, women who drink alcohol during pregnancy risk fetotoxic effects. Screening for at-risk alcohol use is considered best practice during primary care and prenatal care visits and is an integral component of preventive care services for women. The purpose of this brief report is to introduce the Screening, Brief Intervention, and Referral to Treatment (SBIRT) model as it applies to alcohol use and its importance in women's health care services. SBIRT resources are evidence based, allowing the clinician to screen for use of alcohol, implement a brief intervention, and conduct referral to treatment, if necessary. Implementing SBIRT improves recognition of at-risk alcohol use or alcohol use disorder, facilitates awareness and education about use, enhances the referral-to-treatment process, and decreases overall health care costs.