Women's Digital Health

Leveraging Technology to Bridge the Gaps in Perinatal Mental Health Care with Dr. Dhami

• Women's Digital Health • Season 2 • Episode 18

Share episode

This episode contains depictions of suicide and infanticide that you may find disturbing.

Did you know that 20% of pregnant women experience emotional or mood disorders? And while we don't always want to talk about it, suicide during the perinatal period is a leading cause of death in women.

My guest today is Dr. Dhami,  a specialist in perinatal mental health. She shares valuable insights and resources for women facing perinatal mental health conditions and highlights the limited availability of specialized inpatient treatment for those affected.

Topics include:

  • The importance of advocating for oneself when it comes to mental health care during pregnancy and postpartum. 
  • The importance of specialized inpatient treatment for pregnant individuals with emotional and mood disorders, and the need for more resources and programs dedicated to perinatal mental health.
  • Technology's role in improving access to mental health care for pregnant and postpartum women, particularly when combined with in-person evaluation for more severe conditions.

If you need to talk to someone:

  • Reach the National Suicide Prevention Line (USA) by dialing 988 on your phone or 800-273-TALK (800-273-8255).
  • Contact the Trevor Project (for suicide prevention and overall mental well-being of young LGBTQ lives) at https://www.thetrevorproject.org or call 866-488-7386. 
  • For anyone outside the USA, see https://befrienders.org/

Resources mentioned in this episode:

Disclaimer
The information in this podcast is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition or treatment.

The personal views expressed by guests on Women's Digital Health are their own. Their inclusion here does not constitute an endorsement from Dr. Brandi, Women's Digital Health, or associated organizations.

Visit Women's Digital Health and subscribe to our newsletter.

Connect with Women's Digital Health on Instagram, Facebook, LinkedIn, and YouTube.


Dr. Brandi:
Welcome to the Women's Digital Health Podcast, a podcast dedicated to learning more about new digital technologies in women's health. We discuss convenient and accessible solutions that support women with common health conditions. Join us as we explore innovations like mobile health applications, sensors, telehealth, and artificial intelligence, plus more. Learn from a board-certified anesthesiologist the best tips to fill in some of your health experience gaps throughout life's journey. Episode 18 should be used like that piece of paper you put in your pocket. You take it out and maybe you listen to a little bit of it. Maybe you share with a friend that you know might need some of this and then you put it back in. and maybe later on you realize you need a little bit more of this episode. It's okay. We know that this episode is heavy, it's intense, and if you need to listen to it with a friend or talk with a friend about it afterwards, we totally understand.

Dr. Dhami: I had just started working at El Camino. This was in 2006. And then we had a patient at that time that had reached out to us requesting help for depression around pregnancy and postpartum. And at that time we didn't have any tailored resources for, for this unique need. And this patient ended up having a tragic outcome. I believe this was death by suicide. And I think that touched us all pretty deeply.

Dr. Brandi: the unthinkable, or maybe it's the untalkable. No one ever wants to talk about pregnancy and suicide. It's like talking about euphoria and sorrow at the same time. But I've learned in doing this work, if we stay silent, we don't learn. We don't learn about support, resources, and alternatives. And that's where Dr. Dami comes in. Dr. Dami is the Medical Director of Inpatient Perinatal Psychiatry at El Camino Hospital in Mountain View, California. This hospital represents one of three hospitals in the United States that offer specialized inpatient treatment for emotional and mood disorders that pregnant folk need. She's also the founder of Bay Area Maternal Mental Health. And while we don't always want to talk about it, 20% of women experience some emotional or mood disorder during pregnancy and suicide during the perinatal period is a leading cause of death in women. Y'all, I know this topic is heavy and so if you want to save it for a time where you can reflect or maybe you just want to share it with someone who you think might need it, please do that. Remember, if you need to talk to someone, The Suicide Hotline can be reached by dialing 988 or on your phone at 800-273-TALK or 800-273-8255. Trevor Project is available for LGBTQ youth at 866-488-7386. And for anyone outside the U.S., tribebefrienders.org, and we will list those resources, plus all of the resources specific to the perinatal or around pregnancy, after pregnancy resources that Dr. Dami will provide in this episode. And so we promise to put all of the resources that she lists in the show notes on our website. Hello, Dr. Dami. How are you?

Dr. Dhami: I am great. Dr. Sinkfield, thank you for having me this morning.

Dr. Brandi: Yes. Thank you for joining Women's Digital Health. I am just so very thankful that we've had opportunities to talk about this really important topic. I met Dr. Dhami at a women's summit many years ago, and she is the medical director of inpatient perinatal psychiatry and the founder of Bay Area Maternal Mental Health. really focused on reproductive psychiatry, helping women with multiple mental health challenges in a subject that I think a lot of times we are not even aware that there are resources out there that can help women through a pretty big chapter of their life. And we'll talk about all of your expertise and all of the resources that are out here for a lot of moms that could really, really know that Dr. Dami exists and can really benefit from some of the things that you offer in your expertise. So thank you so much for being here.

Dr. Dhami: It's my pleasure. Thank you, Dr. Sinkfield.

Dr. Brandi: And I have to say, Dr. Dami, when I met you, You know, that was, I don't know, at least four or five years ago when we met. I will say that your work has shaped a lot of the things that I'm doing, just trying to improve women's health, trying to remove some of the shame and stigma around topics like mental health. So just thank you for doing that work. And we're going to get into all of the things that you do and why you're such an inspiration to me. And hopefully you continue to be a great resource for the community. So just thank you, Dr. Damme. I really appreciate you.

Dr. Dhami: My pleasure and thank you and I appreciate what you're doing. I think education and outreach and awareness will bring about the much needed change in our mental health landscape.

Dr. Brandi: Yeah, I wholeheartedly agree. All right, so we're going to get into some of the questions. The first question I have is about the pregnancy state. Many times when we talk about pregnancy, the first emotion that many people attach to pregnancy is joy and happiness. And that's understandable. Having said that, sometimes I feel as if women feel as if they are locked into just having joy and happiness. And in other words, there's no room for other emotions to be a part of the pregnancy state. And so my first question to you is, when you're talking about being pregnant, what are some resources in terms of managing mental health that women should know about as they walk through the journey of pregnancy?

Dr. Dhami: So yes, that's well said. First and foremost, I think, and I'll come to resources in a minute, but first and foremost, there are many ranges of emotions that one can experience when one finds out they are pregnant. It can go from anxiety, feeling overwhelmed, getting somewhat sad, feeling confused about how to navigate the healthcare landscape, and of course, feeling joy. And I think the society has images of just joy and happiness, but not all the other feelings that I have seen. And I think most of us have also experienced both ourselves and with patients first-hand. So I think having an understanding of a complete range of emotions is one step. A great organization and a great resource is PSI. It's called Postpartum Support International. They have a lot of information for pregnant moms too. So that is a good place to start. Another useful resource is the International Marce Society. It's a gathering of research scholars as well as clinicians that work in the perinatal mental health field, and they have a meeting every two years and offer, again, a ton of resources and support for moms with pregnancy or postpartum-related mental health condition. There's also womensmentalhealth.org that's out of United States. Mass General, that's another great resource. So these three would be the top ones that come to mind

Dr. Brandi: While there's a lot more understanding now compared to when Dr. Dhami started 20 years ago, the challenge with understanding postpartum or peripartum mood and emotional challenges is that it's not always getting screened and it's not even captured as postpartum. For instance, some people define postpartum as 42 days after you have a baby. Some can define postpartum as long as 365 days. after you deliver a baby. So if you say 42 days is the end of postpartum and you start experiencing anxiety, feelings of loneliness and isolation on day 43 after you have a baby, this event is not always seen as associated with pregnancy and this impacts understanding of where to put resources. Listen to how Dr. Dami navigates understanding her resources and putting together a team to better increase access to the postpartum experience of pregnant persons.

Dr. Dhami: It was just that she reached out to us and we didn't have the resources. And then El Camino launched a community task force and the task force comprised of pediatricians, social workers, psychiatrists, psychologists, OBGYNs. And we did a community survey and everybody pretty much universally said that much more needed to be done. And this was a huge need in the community. To some degree, even health fairs, as well as El Camino's administration, International Marce Day Society, our programs within the United States. It was a program out of Rhode Island at that time. They really supported us. We really stood on their shoulders and I can say they supported me and us in moving forward. This was a new field at that time. Most people didn't know about it. There was a lot of shame and stigma and also fear around prescribing medications and to impact women. But all I can say is there was just this huge community of people and clinicians and lay people, all of who really rallied to support us. That's how it started.

Dr. Brandi: So you mentioned like the challenges with treating pregnant women, particularly with medications, right? What has been your experience now, almost 20 years later on this journey with advocating for treatment for women with prenatal mental health or postpartum challenges with their mental health?

Dr. Dhami: So it's really warmed my heart. I think what we started doing was really the trailblazing work in the field. And it was my heart in terms of how far we've come in our patients. My experience has been that, yes, it's come with its challenges. The primary one being really lack of good research in terms of how to treat a pregnant mom or even a postpartum mom, breastfeeding and medications. But despite all the challenges, I think women, their families and the physicians and other providers that treat them recognize that pregnant women and postpartum women get sick. And women who have pre-existing mental health conditions can get pregnant and we need to treat them. So it really warms my heart to see how far we've come in terms of accepting these as normal conditions and understanding that most of them are treatable. I still think we have a long ways to go in terms of access to care and appropriate care, but it's just heartwarming how far we've come.

Dr. Brandi: Thank you for saying that, because that was my next question. If I were a pregnant woman and I'm coming to see my obstetrician about a regular visit, what are some ways in which I might even broach the subject that I'm feeling anxious or, you know, I'm not sleeping, such that an obstetrician can decide whether or not I need maybe just a massage versus really getting mental health care that could be life-changing for that woman and her child.

Dr. Dhami: Number one, and this is something I tell all my patients, is that they have to be their own advocates. Yes. Especially in the mental health and even in the medical field landscape that we deal with. Keep in mind that your OBDs are times, they're really stretched for time, so you have to be tested, okay? And this is where technology comes in, you know, document your symptoms, even if they seem vague to you. Just write it down, so that when you meet your doctor, you can say, for the past two weeks, I was waking up with tears, or I was not able to sleep, or I'm having these thoughts that something might go wrong with the pregnancy, and these thoughts keep coming back to me. That's number one. Number two, I encourage family members to do the same. So if you see a change in your partner, a change from their baseline that is concerning to you, write that down. And if you can make it to the OP's visit, call them and give them the information. But I do think educating oneself about it and then taking that to your obstetrician is the first step. Another thing, Dr. Sinkfield, that patients can do pretty easily is, you know, you can Google EPDS, Edinburgh Postpartum Depression Scale. It's called postpartum or postnatal depression scale, but it has, it can be used in pregnant moms too, and can be used for depression and bipolar illness. And it's just a screening tool. Just look at it and see some of the questions they have, and see if you have any of those symptoms. And again, write those down, take them to your doctor, and ask the doctor for suggestions and resources. And as you said, there is a whole range of resources. You can go from talking to a peer counselor to getting formal therapy to taking both medications and therapy. And sometimes, you know, if things are really serious, getting admitted to an inpatient unit briefly so you can be stabilized with the help of a multidisciplinary team. and then have a much more smoother course of pregnancy and postpartum. Thank you.

Dr. Brandi: I think that answers a lot of questions for a lot of persons who wish to become pregnant or currently are pregnant. You know, giving them this landscape of, yes, you can get counseling. You know, first step is to advocate for yourself. Yes, you can get medications while you're pregnant. And yes, there are specific resources that you can even go to that may require inpatient treatment. I don't think a lot of people know that that even exists. And so it's just calming to me to even know that there's something out here for pregnant women, because a lot of people just feel completely trapped. They're just like, you just have to deal with it. I dealt with it, so you have to deal with it too. And that's just not the case.

Dr. Dhami: Yes. And I think looping back to your former question about my journey. So as we built our outpatient program, El Camino team and myself, we realized very fast that the needs of our moms, our patients exceeded what we were offering through our outpatient resources. And we realized that they needed specialized treatment when they were admitted to an inpatient unit. And then our next wave of advocacy, and this time we had a whole team of women who were willing to stand up and say, you know, this happened to me, and this is what is needed, and this is treatable, and we need to get the treatment. And so that led to the following step. And I think it was 2020 when we opened our inpatient perinatal unit at El Camino, right in the midst of COVID.

Dr. Brandi: Probably when it was needed the most. Yeah, I'm sure. Any other inpatient clinics that you know of for prenatal or postpartum women dealing with mental health conditions?

Dr. Dhami: So, unfortunately, Dr. Singhal, this is where, like, my heart, this is where I feel sad about our landscape. Yes, there are several, about a handful or maybe two handfuls of partial and intensive outpatient programs in the United States. And if you look up the Postpartum Support International website, you'll get a listing of all of them. El Camino has probably the most depth and range of programs anywhere in the country. So we offer day treatment programs, which is a mom can come in with a baby or can come in when she's pregnant and get treatment every day and go back home at night. And then we offer what's inpatient perinatal unit. And based on my knowledge as of a month ago, I think there are only two other such units. One is in North Carolina and there's one in New York. And ours is the only one on the West Coast. And it is really disheartening and sad to see that situation here as compared to other parts of the world. For example, England has about, I think, about 20 such units. It's quite disheartening. If a woman was to get a serious mental health condition, either in pregnancy or postpartum, There is no tailored treatment that's available to them. They are put in the general psych ward with patients with all sorts of disorders and no work is done around understanding motherhood. And then they get discharged to the community. and are expected to function. We're really failing to address that big gap and we just have these three places for them.

Dr. Brandi: I want to shift a little bit towards what the consequences could be if you're not getting the specialized help. What are some potential experiences that you've seen in mothers who you know, are shifted to the general adult psychiatry inpatient as opposed to getting specialized treatment?

Dr. Dhami: I can go on and on on this. I can tell you what comes to mind and I'm really hoping that this podcast has that reach so people can just call us directly and get help. But oftentimes our nursing team will get phone calls from parents of potential patients saying that this patient had been admitted to two different psychiatry wards and has been discharged and now is readmitted somewhere else and it's just not going to work out and can you help us. Sometimes we get phone calls from partners saying, you know, their partner is really struggling, has been struggling for several months. They've taken them to an ER five times and they keep getting discharged and they just don't know what to do. Right. The one case that comes to mind was the patient who had no prior mental health history and delivered her baby and then got acutely depressed and I believe went to an emergency room and I think told the doctor that she was fine at that time and she'd be okay and was discharged. She had a very serious suicide attempt. And then she went back to the ER, got admitted to a hospital that was about 200 miles away because I was the only one with a bed available. And then got discharged from there and was referred to some virtual program. And again, none of this was catered to her postnatal state. And while in the program, she had a very serious suicide attempt. And I don't know how she survived, but anyway, she had a long medical hospitalization following the injuries from that attempt. And eventually someone referred her to us. And we accepted her and she was treated for about a couple of months on our inpatient unit and discharged and she's made a full recovery. You know, it's all hindsight, I understand. And there are many nuances in our field, but I do think if she had received the treatment that she needed to receive in the very beginning, we might have, we might have changed the course of her illness. So these are some of the examples of patients that come to us.

Dr. Brandi: I think you bring up a great point because you mentioned the parents of the mother. You also mentioned the partners of the person who had just recently had a child. If you tell me how might, you know, we improve the way that our families and our community understand that these resources exist, because, you know, I'm imagining if you are the mother who's experiencing all of these ranges of emotions, you're not in a state to really be thinking about all these resources you can look into. Can you tell me how you navigate getting the conversation to the family and communities of these people who could benefit from these resources?

Dr. Dhami: Well, I navigated by doing things like that. Yeah. But what I really want to point out is, yes, parents and spouses and partners reach out to us. I think it's our job as doctors who Any doctor that cares for a pregnant mom or a postpartum mom or someone who's thinking of getting pregnant needs to educate themselves about the incidence and prevalence of these conditions and refer patients appropriately. I think it's our job. It's our duty. It's the right thing to do. It's the ethical thing to do. And I think the same goes for hospitals. If you have a mom that's pregnant and postnatal and you are not providing her with the tailored care that we know works for these conditions, it's your job to refer them to somebody that provides it, regardless of pair status or You know, whatever the administration says, I think put the patient first. And you're absolutely right, Dr. Sinquefield, when a mom is struggling with depression, anxiety, bipolar illness, worried about breastfeeding, or what's going to happen next to her, financial issues. She cannot diagnose herself. So anyone who works with these women, including emergency room doctors, I think it's our ethical duty to educate ourselves and refer the patients to appropriate places where they can get the treatment because we know that treatment works.

Dr. Brandi: Yeah, it does. It does. I mean, to your point, it's the delay in care that really can impact your long term return to a quality of life. Yes, for sure. This podcast and many other conversations like this, I hope to bring more awareness to this issue. Hey listeners, it's Dr. Brandy. Thanks for listening to this episode of Women's Digital Health. Subscribe to Women's Digital Health on your favorite podcast platform. If you want to know even more about how to use technology to improve your health, subscribe to our newsletter on womensdigitalhealth.com. Follow us on Instagram, Facebook, YouTube, and LinkedIn. Enjoy the rest of this episode. I want to shift a little bit towards technology. I know we were talking about, you know, kind of the ways in which we're trying to make health care more accessible to a lot of people. And one of the ways in which we do this is through telehealth. In other words, a virtual care similar to this, where you can reach your doctor virtually. You don't have to leave your home. You can reach your doctor where you are. How common is it to get telehealth mental health care for unique populations like the perinatal postpartum population?

Dr. Dhami: Dr. Singfield, I don't know the specifics of how common. I can comment on a few things. I'd say number one is a lot of emergency rooms now have telehealth psychiatry services. And so when a mom goes to the ER saying, I'm depressed, or I don't know what's going on with me, or the family says, I don't know what's wrong with my wife, she's just changed. And they see a psychiatrist for telehealth, I think that is one starting point, important point, and a place to catch some of these things. I do think that telehealth has opened a lot of doors for us in terms of reaching to communities where we have not been able to reach for a multitude of reasons. So I do think it plays an important role. I just want to be careful about one thing. If you are dealing with symptoms that are severe and affecting your functioning, that is affecting your safety, then I think telehealth may not be the ideal choice. It could be a starting point, but in-person evaluation would be helpful. However, if we're dealing with symptoms that are mild to moderate in range and, you know, patients need access to resources or suggestions about medications, I think it's great to have that as an accessible resource. So I would say a blend of both telehealth and in-person face-to-face treatment both have their role depending on the severity of the condition.

Dr. Brandi: So if you were in a place where let's say you don't have an inpatient perinatal program, but you do have telehealth. Are psychiatrists who are part of the telehealth community aware that they could refer to an inpatient? How would they get access to specific programs like the Perinatal Inpatient Clinic?

Dr. Dhami: So yes, now there is a curriculum that's being created to educate residents and other physicians in this field. Much needed, but finally it's there. Okay. And I think in terms of reaching to us, they just have to make a phone call and I'll give out that number. So this is a direct number that monitored by our nurse managers around the clock. You will get an answer. It may not be right away, but within sometime, usually a few hours, you will get an answer. Okay. And they will call and help the patient navigate the situation, help the family navigate the situation. Or the physician or the provider who calls, we will work with them too. Okay. It's 650-988-8468. 650-988-8468 and then option one. Okay. So that's for our inpatient perinatal and anybody can call. Usually we want providers to call us and give us some information, but if the partners call, we will help them understand what's going on and help them talk to the providers and assess the situation and guide them through the process. And we've had patients come from many places in California, but also out of state to get treatment.

Dr. Brandi: Thank you so much for that, Dr. Dhami. The other question I have is about another technology that I know we talked briefly about. I'm new to this. And so I was really intrigued by the use of artificial intelligence being used to address mental health. And specifically, there's this idea that chatbot can be used in conjunction with a psychiatrist like yourself to reinforce cognitive behavior therapy or other types of therapy to really improve mental health. And some of these companies are specifically targeting women with postpartum depression. And I wanted to get your perspective, like, where are we in the landscape of using these digital therapeutics, these chatbots to assist with common perinatal conditions like postpartum depression?

Dr. Dhami: Well, I think that it's a big field and it's exploding. You're right. There are lots and lots of people that are venturing into the field. My bias is on the other side because I treat a lot of severe mental illness. I'm, of course, very cautious about any form of chat bot. But I do think there is a place for technology to help with specific, I would say, day-to-day functioning, suggestions for therapy to help with Sleep regulation. I recall during the COVID times, there was a great app called COVID Coach that was created by the VA. It was incredibly helpful. And I recall giving that out to patients and them using it for basic life skills like sleep regulation, activities of daily living. And so I think that it's helpful if your symptoms are in the mild or moderate-ish range. But I think beyond that, the patient will probably need in-person evaluation. But there is a role, and I'm actually really glad that people are thinking about postpartum depression and thinking about all these various tools to connect with patients and help them. So I'm grateful for that. My own anecdotal experience in working with some other people in the past has been that it, again, as I said before, targets mild to moderate-ish symptoms. If once your symptoms exceed the moderate category, I think getting help from your doctor and other providers is crucial. And by mild to moderate, I mean symptoms that don't really affect activities of daily living. Right. So if you're functioning okay and you're feeling low mood and having some crying spells and some anxiety and maybe, maybe an intrusive thought here and there, then I think technology that's geared towards addressing those symptoms could be quite helpful. Thank you for that.

Dr. Brandi: And just to kind of recap, it sounds like the evaluation is really important first to determine even if you have mild or moderate. So you still have to have that evaluation first. It's determined whether or not adding something like a technology like a CHAPA or a digital therapeutic is going to be beneficial. So this is not something that's standalone. It's something that would have to come with an evaluation and then a recommendation that this could be beneficial to you.

Dr. Dhami: Yeah, I like how you frame it, Dr. Sinkfield, I think in conjunction. So get it out again and then use these technologies in conjunction. I think they can be quite helpful. I mean, I get a reminder I need to work out every day. It's quite helpful. Right. And so I think they have a role. But I also want to underscore that mood symptoms in pregnancy and postpartum can wax and wane. And for a lot of women, we're just used to doing so much. And there is a significant minimizing of symptoms. And I want patients to be careful about that. Patients and families that, yes, you know, online help, digital help is great, but Try not to minimize your symptoms because catch the condition early, get it treated and have a great outcome.

Dr. Brandi: I love that. Thank you for that. Speaking of that, you know, the shame and like loss of dignity, those are some of the emotions that I hear from a lot of women who are secretly struggling with all of these different emotions that we've discussed. And I just want to know, Aside from going to your physician, how do we improve access to care to these women? I mean, is this something that happens well before you become pregnant? Is this something that happens through, you know, obviously we're having this podcast that that's one way, but what have been some other channels that you've seen that really can improve women becoming less shameful about talking about some of their emotions around the prenatal and postpartum experience?

Dr. Dhami: Most of the channels focus on education and normalizing a lot of symptoms. A lot of my inspiration comes from the Marseilles Society and just how normal as part of the medical spectrum, these perinatal mental health conditions are. But what I've typically used is education in terms of doing grand rounds, in local organizations. And that has had some impact. There are also a lot of grassroot organizations that are doing work and have specific days, like postpartum psychosis awareness day. Another avenue that I delved into last year was filmmaking. Well, actually, two years ago, I made a couple of small films with a couple of high school students on perineal anxiety. perinatal depression and anxiety in physicians. And the second one was the consequences of untreated perinatal mental health conditions. So that's another avenue of education and dissemination of information. And then last year I worked closely with two students and we made a film on the legal system and how it treats women with psychiatric conditions and what we can do to bring about change. And our film is actually going to be featured in the Mars Day conference that's coming up in Barcelona this year.

Dr. Brandi: That's awesome. I would definitely love to get the links to that and to share that with our listeners. You mentioned the legal system. Can you tell me how the legal system impacts this perinatal postpartum community? Where is the intersection there?

Dr. Dhami: That's again a system with many challenges and a lot more needs to be done. The laws that we have are archaic. They're about 180 years old and we use those to make their decisions. That's what it is. I also think that when a mom is struggling with serious mental illness and Whether there is harm to baby or not, the lens through which we look at their condition is not unique to perinatal mental health conditions. So we think of them as a regular, you know, someone who murders a person in a drug deal. That's how we look at them. And oftentimes these women are incarcerated and serve long sentences in jails and prisons without any treatment for their mental health condition. So we're really, really far behind in terms of, again, you know, Europe, there are several countries that have infanticide acts. We don't have any of that in America. There is some change that is coming. And it's, again, based on individual advocacy by different providers who have been, who are just shocked at what's happening. But it is a very sad situation and I do think that women who don't have financial resources or culturally are at a disadvantage suffer more. So yes, a lot more needs to be done and should be done to understand postpartum psychosis. infanticide and all those conditions and offer people education and treatment. It's just a lot more needs to be done.

Dr. Brandi: You know, we are all experiencing, you know, as a nation, some of the consequences of the lack of resources. And so, again, you know, I can't thank you enough for even having The expertise that you have and the opportunity to increase the access to those who really need it. I know it took us a while to get together. but I just really appreciate your time. Are there any other resources that you wanted to share with our listeners about access, maybe at your hospital or other hospitals or other resources that you haven't mentioned?

Dr. Dhami: El Camino also does a free symposium. It's free and open to public. We do it once a year, and we get world-renowned experts to offer free education on perinatal mental health conditions. Our date is September 27th, and I do think this will be advertised on El Camino Health's website, but it's free. Anybody can join. You don't have to pay, just register. It's through Zoom, so it's widely accessible, and last year we had about 1,500 people from several different countries. It's a very good resource to hear about the latest that's happening in our field, both in terms of medication management and psychotherapy. And you also get to hear stories from patients who've gone through this process, what worked for them and what didn't. So it's overall a very inspiring and educational event, and you get free CMEs. So please join. We have a great panel already lined up.

Dr. Brandi: Dr. Dhami, thank you again. It was a true pleasure having you on, and maybe we'll have you back.

Dr. Dhami: You're very welcome, Dr. Sinkfield. Thank you for the opportunity.

Dr. Brandi: That concludes episode 18, where we discussed mood and emotional challenges during and after pregnancy. We talked about the use of medication during pregnancy, getting resources to not just pregnant mothers, but their partners and their families, and using technologies like artificial intelligence and telehealth to increase access to this population. Mood and emotional challenges affect 20% of pregnant folks. So I hope that you use this episode in the way that you need it. Share this resource with whomever you think needs it. All the resources to get access to mental health care during the pregnancy and postpartum period will be listed on our website and in our show notes. If you want more information, please subscribe to our newsletter and follow us on all our socials. Bye for now. Although I'm a board-certified physician, I am not your physician. All content and information on this podcast is for informational and educational purposes only. It does not constitute medical advice and it does not establish a doctor-patient relationship by listening to this podcast. Never disregard professional medical advice or delay in seeking it because of something you heard on this podcast. The personal views of our podcast guests on women's digital health are their own and do not replace medical professional advice.