A new study explores new methods to enhance access to crucial mental health care for pregnant and postpartum individuals, demonstrating the efficacy of task-sharing and telemedicine.
In a world where approximately 20% of pregnant and postpartum individuals struggle with depression and anxiety, yet fewer than 10% receive appropriate treatment, the results of a new study offer a ray of hope. The Scaling Up Maternal Mental Health care by Increasing access to Treatment (SUMMIT) Trial, one of the largest psychotherapy trials ever conducted, promises to reshape mental health care accessibility during and after pregnancy.
The trial, detailed in a paper published in Nature Medicine, explored whether talk therapy could be effectively delivered by non-mental health specialists and through telemedicine. This approach aims to address the significant gap in access to mental health care for new parents, exacerbated by a shortage of specialists and rising health care costs.
“Talk therapy is effective but largely inaccessible. As our health systems grapple with a shortage of specialists and the rising costs of care, many pregnant and post-partum individuals suffer in silence. Leveraging simple, pragmatic solutions of task-sharing and telemedicine has the potential to transform health care and improve access to essential mental health services,” Daisy Singla, the lead principal investigator of SUMMIT, said in a news release. Singla holds prominent roles at the Lunenfeld-Tanenbaum Research Institute, Sinai Health, the Centre for Addiction and Mental Health (CAMH) and the University of Toronto.
The study was conducted across multiple sites in North America, including Mount Sinai Hospital and St. Michael’s Hospital in Toronto, the Women’s and Neuroscience Hospitals associated with the University of North Carolina (UNC) in Chapel Hill, and Endeavor Health in Chicago.
A total of 1,230 pregnant and postpartum individuals participated, nearly half of whom identified as racialized minorities.
The participants received between six and eight weekly sessions of Behavioral Activation, a form of talk therapy focused on encouraging meaningful activities aligned with personal values. Those treated by trained non-specialists — nurses, midwives and doulas — showed significant improvement in their symptoms of depression and anxiety, similar to those treated by psychologists and psychiatrists.
The average depression scores fell from 16 to 9 on the Edinburgh Postnatal Depression Scale, while anxiety scores dropped from 12 to 7 on the General Anxiety Disorder-7 scale.
“Our research shows that a collaborative model in real-world health-care systems involving both specialists and trained non-specialists could significantly reduce wait times and expand access to effective, quality mental health care,” added Samantha Meltzer-Brody, co-principal investigator of SUMMIT and site lead at UNC Chapel Hill.
Behavioral Activation training for non-specialist providers included comprehensive instruction and role-play exercises, totaling 20-25 hours.
“Finding effective ways to treat these patients is critical – and specifically, ways that don’t involve medication, which some would rather avoid while pregnant or breastfeeding. We need a safe and effective alternative treatment — talk therapy can help fill this gap,” added Richard Silver, chair of obstetrics & gynecology at Endeavor Health and site lead at Endeavor Health.
Untreated, depression and anxiety can lead to severe consequences, such as maternal mortality, obstetrical complications and developmental issues in children. This study underscores the urgent need to invest in perinatal mental health care.
“Investing in perinatal mental health means investing in a healthier, more equitable future for parents, their children and our communities at large,” Singla added.
The research team is also evaluating the economic viability of these innovative approaches within the Canadian and U.S. health care systems to ensure sustainability and broader implementation.
The SUMMIT Trial marks a pivotal step toward inclusive and accessible mental health care for pregnant and postpartum individuals, offering hope and tangible solutions to millions of families worldwide.