Studying Perinatal Well-being with Adrienne Griffen

Listen to this month’s episode with Adrienne Griffen, who offers strategic recommendations for increasing policy engagement to address perinatal mental health needs. As a national perinatal mental health advocate with more than two decades of experience, Griffen provides listeners with insightful steps to expand on the incredible work of non-profit organizations like the Maternal Mental Health Leadership Alliance (mmhla.org). 

 Adrienne Griffen, MPP, is the Executive Director of the Maternal Mental Health Leadership Alliance (mmhla.org) and a nationally recognized advocate and subject matter expert in maternal mental health. Fueled by her lived experience with postpartum depression, Adrienne has led two non-profit organizations addressing maternal mental health. She is a featured speaker at national conferences and events. She has advocated for more than $200 million in federal funding for maternal mental health programs, which resulted in $68.5 million funded.

 Adrienne graduated from the US Naval Academy with a Master's in Public Policy from Harvard’s Kennedy School of Government. Her early career included military and federal government service at the White House, Pentagon, and IRS.

Transcript

Dr. Lara-Cinisomo [00:00:04] Welcome to Studying Perinatal Well-being, the podcast of the Marcé of North America. This bilingual monthly podcast will allow new and experienced researchers, practitioners, students, and community members to hear about the latest research and community actions on perinatal well-being. I am Dr. Sandraluz Lara-Cinisomo, your host. Adrienne Griffen is a nationally recognized advocate and subject matter expert in maternal mental health. Fueled by her lived experience with postpartum depression, Adrienne has led two nonprofit organizations addressing maternal mental health and is a featured speaker at national conferences and events. Her advocacy efforts have resulted in almost $200 million in federal funding for maternal mental health programs. Adrian graduated from the U.S. Naval Academy with a Master's in Public Policy from Harvard's Kennedy School of Government. Her early career included military and federal government service at the White House, Pentagon, and IRS. Welcome, Adrienne. 

Griffen [00:01:04] Thank you, Sandraluz, it's a delight to be here. Thank you for inviting me to be on the podcast. 

Dr. Lara-Cinisomo [00:01:09] You’re welcome, I'm so glad you were able to make some time for us. So why don't we go ahead and get started? Let's begin by learning a little bit about you. How did you become interested in perinatal mental health? 

Griffen [00:01:19] Well, you know what? I call myself an accidental advocate. Because if you had told me before I had children that I would be doing any of this kind of work, I would have laughed at you because I knew nothing about mental health. In fact, I, you know, was in the military before I had children, and there was no mental health in the military, like you just keep marching, right? And, you know, so I really had no idea that I would do this work until I had an experience with postpartum depression with my son, who is now almost, he's graduating from college next month. And, yeah, he's the second of my three children. And, you know, I knew right away that something was wrong. I had a scary emergency C-section, and I realized that he probably would have died if we hadn't been in the hospital. And I really remember just lying on the operating room table like what just happened to me? I really feel like my brain had been fried. And I remember I kept saying to people afterwards, you know, if I had just gone through labor and delivery like I did with my first child, maybe I would be okay. Like what is going on here? And it took me, even though I knew something was wrong right away, like I made an excuse to go back and visit my obstetrician at like two weeks postpartum. I was like, my C-section scar isn't healing,  I need to come in and see you. And, you know, I said to her, I'm really not doing very well. And she said, well, do you want Prozac? And I was like, well, could we talk about why I might need it? And so she gave me a card for behavioral health. I was like, what's behavioral health? What does that even mean? I had never been exposed to anything in the mental health system, behavioral health system. And then it took me like six months of, of trying to get help to finally get what I needed. And so I just vowed during that dark time in my life that I was going to do something to help other mothers. And so we had another child, and then eventually, you know, kid went off to school and I started volunteering for Postpartum Support International. And then, you know, it just led from there. 

Dr. Lara-Cinisomo [00:03:19] Well, thank you for sharing your story. It's amazing that you were able to advocate for yourself, though it sounds like it took about six months, you were able to advocate for yourself. 

Griffen [00:03:30] Yeah. And that's partly why I decided that I needed to do something more, because I kept thinking about how hard it was for me. And I know I live outside of Washington, D.C. it's not like I'm out in some, you know, maternity care desert, I speak English, I have a husband,  I have insurance, I had the internet, I had family support, and I was like, what about people who may not recognize that something's wrong and don't know how to advocate for themselves or don't have the perseverance to keep doing it so they get the help that they needed? And so yeah, all of that was the reason why I decided to, to do this work. Yeah.

Dr. Lara-Cinisomo [00:04:07] And for some people they are never heard because of their background, how they look, how they speak, and so it's great that you're advocating for perinatal mental health. Now, I mentioned in the intro that you have a master's from the Kennedy School of Government and Public Policy. How has that training informed your work around policy and advocacy around perinatal mental health? 

Griffen [00:04:29] Yeah, so it's really interesting how, like, all of these streams of your life converge, right, and so I did have this public policy degree, and I had been working in the fields of military intelligence and international relations. And so that's where I was really using that policy, working again until I had children, and then sort of did this big pivot. And it was sort of like, well, I know how to do this policy work. And now there's this issue. How about if I bring them together? And so in this policy world, there's this expression about these different streams kind of interacting. And so there's the problem stream and there's the policy stream, and then there's the politics stream. And when the three of those streams kind of align, that's when the window of opportunity opens and you can actually get something done. And I really think that's where we are in our country right now. Right. We understand what the problem is. We've been talking about that for a long time. Now we have some policy solutions, whether it's The National Maternal Mental Health Hotline or the, Psychiatry Access Programs. And we have lots of policy opportunities. And the politics stream is starting to align. People in Congress and people at the national level understand that mental health is a real issue, and it's a bipartisan issue. And so we, I think we're really poised right now for the next little bit of time, however long that is, to actually get some of these policy wins in place. 

Dr. Lara-Cinisomo [00:05:55] Well, that's really strategic. You know, we don't talk a whole lot about strategy with regard to addressing some critical issues in this country and abroad, but you have identified a window of opportunity to bring those different strains together. 

Griffen [00:06:12] Well, it's you know, it's not just me. I'll say, for example, I've been working on the National Maternal Mental Health Task Force for the last four months or so. And this was legislation that was introduced by Joy Burkhard at the Policy Center for Maternal Mental Health, and it's really going to be a game changer because this national task force is writing both a report to Congress about here's the current state of play at the national level, as well as making a lot of recommendations, recommendations that we in the field have been talking about for a long time, things about reimbursement to make sure that medical providers, and mental health providers in particular, are adequately reimbursed for their work. More information about educating consumers, you know, women, parents experiencing these issues, but also educating providers, making sure that issues about maternal mental health, perinatal mental health are included in curricula for medical students and for nursing students and for community-based providers. And so, I think we're going to see sort of this report and the strategy are really going to lay out a lot of things all packaged together that many of us have been talking about for a long time. 

Dr. Lara-Cinisomo [00:07:23] Yeah, that's amazing that you're addressing this issue at multiple levels and starting with the training all the way through, hopefully some policy. And, I wondered whether you talked about how to address this, given the diversity in parenting experiences, in perinatal experiences, perinatal populations, have that conversation come up in the work that you've been doing? 

Griffen [00:07:48] Absolutely. We always bring an eye to diversity and racial and health equity in all of the work that we do. And again, in that task force, it has been a common theme, a constant theme, to make sure that care is equitable, accessible and affordable. Right? It's got to be all of those things. And in some other work that we've been doing, I've been leading this project at Maternal Mental Health Leadership Alliance, called the Screening Project, where we came up over the first year or so, we came up with a framework focused specifically on when to screen pregnant and postpartum people during a two year perinatal time frame. And everybody's like, oh, that's a great framework, but there's all these barriers to screening. And one of which is that the screening tools that we currently use are not racially or culturally sensitive or appropriate from our very diverse population in the United States. Right. When we think about the EPDS, for example, which so many people use, and it's been a great screening tool, but it's over 40 years old, and, you know, it was written for a white audience. Right? And so how do we take some of these screening tools and make them more culturally and racially relevant, as well as, maybe we need a screening tool that starts from the bottom and is built to be inclusive and robust and screens for anxiety and depression and other things, and you know, really takes into account the very diverse audience that we're screening now. So those are two, and so we're working sort of short term and long term. We've identified a team of people at Virginia Commonwealth University who are updating EPDS to make it more user friendly, right. Taking basically the same thing but changing some of the words slightly so that removing some of the qualifiers and just making it more up to date. And in the meantime, we also identified a team of researchers who are applying for grants, to basically like start from ground zero and build a new screening tool. Yeah, that's, it’s just exciting to see all of this work happening. 

Dr. Lara-Cinisomo [00:09:55] Yeah. So you really are reaching out to a number of stakeholders. 

Griffen [00:09:59] Yes. Yeah.

Dr. Lara-Cinisomo [00:10:00]  Researchers and community members. It sounds like, how is the community involved in this work? 

Griffen [00:10:06] Oh, absolutely. Community is always involved. So for example, on the screening project, the first year we did a number of focus groups, I think we did about 10 or 11 different focus groups. And everybody from moms with lived experience, nurses, doctors, advocates. I remember we did one focus group that was specifically Native American women. We did one that was Spanish speaking women, so that we were including the voices of lived experience and people from various communities from the get go. 

Dr. Lara-Cinisomo [00:10:36] Wow. That's tremendous. And will you publish this work or are the results or is this informing the policy you're advocating for now?  

Griffen [00:10:44] So a little bit of both. So this screening project published a report oh gosh, a year ago, January. And that was sort of laying out the whole framework for when to screen and the process that we went through and all of these focus groups and whatnot. And now we've been working on addressing these barriers to screening. And so, yes, we'll have some follow up work around that, whether it's a paper or an article, I'm not quite sure yet. And it's also impacting, you know, the policy work as well. Yeah. 

Dr. Lara-Cinisomo [00:11:09] Yeah. So this is important work that probably was informed by other work you've done. For example, you founded the Postpartum Support Virginia Organization nonprofit, is that right? 

Griffen [00:11:22] That's right, that's right. So. Right. So I said, you know, how I got involved with this work initially was through Postpartum Support International (PSI). So way back, gosh my kids were still little, so this was like maybe 2005 or 2006, I started as one of the local coordinators in Virginia. And so I would respond to phone calls and emails from moms who would call PSI who were from Virginia, and then they would, you know, pass them off to me. And I really loved doing all of that work, but I'm such a Type-A, you know, overachiever that I was like, I can't just be a volunteer. I need to start my own nonprofit. And so I started Postpartum Support Virginia in 2009, and this was before PSI their current chapter structure. And so it sort of was like a mini PSI in Virginia. Ran that for ten years. And I love it. We did all kinds of stuff. We, you know, supported moms and dads through email and phone calls. We ran support groups, we trained other people to run support groups. And now there's a network of support groups all across the state of Virginia. We did these local coalitions, which was really great. We would get funding from like the local hospital or local community foundation, and we would bring together folks in a particular city, you know, nursing staff from the hospital, providers from the community and the whole visiting programs. And, you know, bring everybody together on a monthly basis to talk about these issues. Who is doing what, what resources are available, love doing all of that. So I did that for about ten years until I had this opportunity to come to the national level, because I used to sit there in Virginia and be like, why? What about - ? Why isn't somebody doing that at the national level? Or what about that or what about that? And so I was like, well, maybe I'm that person. I need to step up and do it. So yeah, yeah.

Dr. Lara-Cinisomo [00:12:58] Yeah. So, you're founding executive director of the Maternal Mental Health Leadership Alliance. And is that the work you're referencing to, the national level? 

Griffen [00:13:10] Yes. Yeah. 

Dr. Lara-Cinisomo [00:13:10] So you went from state to national? 

Griffen [00:13:13] Yeah. Made the big leap. Yeah. 

Dr. Lara-Cinisomo [00:13:14] Can you tell us a little bit about what that's like to make the transition from a state, which is a huge endeavor, to then going into a national platform? 

Griffen [00:13:23] Oh my gosh. Well, just completely different people. And so it was like learning, I mean, starting all over, right? Who was at play at the national level. You know, there's lots of mental health organizations at the national level, National Alliance on Mental Illness, Mental Health America, and lots of organizations focused on maternal or child health. You know, ACON, the American Academy of Pediatrics. Yeah, 0 to 3. But nobody was really focusing on that little intersection of maternal health and mental health. And so that's where the Maternal Mental Health Leadership Alliance really very narrowly focuses. But it's coordinating with all of those different groups. Right. So I'm like on the mental health liaison committee, which is all the mental health organizations. And then, you know, there's all of the maternal child health organizations. And so we really try to bring them together and focus on this little area of overlap that we in the reproductive mental health community, like that's where we find our home. 

Dr. Lara-Cinisomo [00:14:21] Yeah. And so you get to interface with other organizations and that have there are an important focus, definitely important for perinatal mental health in general. What is it like to interact with a large number of organizations? I can imagine that it could be very rewarding, but also it could be, challenging to some extent, given all of the roles that you have to play in different, on different task force or committees. How do you manage all of that? 

Griffen [00:14:53] Oh my gosh, how do any of us manage all that we do? I always look at all of you in the academic settings, and I was like, oh my gosh, how do you manage so much? You teach and you do research in your clinic and you do things on the side like this, like podcast, like, I don't know, just the people who work in this field. We're all still committed. Most of us in the advocacy world is because of our lived experience. You know, whether it's our personal experience or somebody in our family or, you know, I'm always so fascinated when I talk with clinicians, with providers and they're like, you know, there was this one patient who, like, really changed my life because of their experience. And so, lots of organization. I some really great staff members, who help keep us organized. And we really try to stay very, very narrow in our focus. Right. Maternal mental health. And we specifically focus on national policy. And so, you know, we're always trying to scope it back down. And we do three things: so we advocate for change, we build partnerships, and we curate information for the field. And that's it. We try to stay in those three things. If it doesn't fit in those three things, we don't do it. We try to connect with somebody else who does this work in, in a different sphere. And so yes, and we stay very narrow, like we say national policy. Right. There's others that do state policy really, we really try to stay very narrow. So we don't burn out. We don't try to take on too many things. And so then eventually everything kind of aligns if you stay true to your mission. 

Dr. Lara-Cinisomo [00:16:21] Yeah, that's really smart to say. Here are our foci these are the things that we need to make sure that is front and center for us. 

Griffen [00:16:30] Yes, yes, yes. And to be very clear about that. So other organizations know okay, this is what MMHLA (Maternal Mental Health Leadership Alliance) is going to take on, so then we'll take on this. Right. There's, there's so few of us relatively speaking, doing this work that we don't need any overlap. Right. We all need to be very clear in what it is that we're doing, right, so that we can all maximize our, our efforts. 

Dr. Lara-Cinisomo [00:16:52] And who's your audience for MMHLA? Who -  I get your emails and really appreciate all of the content you provide with funding opportunities and webinars and things to look for. But who else is, in addition to someone like me who's a researcher and advocate, perinatal mental health advocate, who else is your audience? 

Griffen [00:17:12] Yeah, so we're very clear. Again, we have three primary audiences. Our first is policymakers. Right. And so whether that's elected officials or their staff members or people who work in advocacy organizations, membership organizations, so sort of policymakers are first at both the federal and the state level. And then providers. And I say that loosely, but people like you, Sandraluz, who are researchers or perinatal mental health professionals or maternal child health care professionals. And so that's sort of like who we're trying to educate about these issues. And then people with lived experience, so fellow advocates. We are not the organization for people who are seeking help right now. Right. That's Postpartum Support International. And we make that very clear on our website, if you're a mom or dad seeking help, here's where you need to go. We are really much more focused on sort of that patient and policy, and yes, Folks who are already sort of working in this field. 

Dr. Lara-Cinisomo [00:18:09] Yeah. Once again, having a narrow focus allows you to provide information that will be useful for those individuals. But I imagine that there probably are a lot of community members with lived experience or who are looking for resources for their loved one, but then you can refer them out to, say, Postpartum Support International. 

Griffen [00:18:31] Exactly, exactly. And, you know, it helps us against a very, very tight like, I'll come up with some harebrained idea and my step will be like, does that fit in with one of our three key audiences? I'm like, I guess you're right. Okay, we'll move that one to the side, right? It does really help us say yes or no to certain things. Yeah. 

Dr. Lara-Cinisomo [00:18:48] And having someone say yes to use probably, very important say like around funding. I said in the intro that you helped, raise about $200 million in federal funding for maternal mental health programs. Tell me a little bit about that work and how many, how many yeses did that require? I believe, but I imagine that took a lot of, knocking on doors and, figuratively, but also maybe truly knocking on policymakers doors. Can you tell us a little bit about that fundraising work? 

Griffen [00:19:18] Absolutely. So this is the key part of, one of, one of the key things that we do, which is this advocating for change. And so basically what we do is advocate with Congress about funding projects, programs and the way Congress works on funding these things, and so typically like a five year commitment. And so the first one was the Bringing Postpartum Depression out of the Shadows Act of 2015. And so it's really the first time any advocates were addressing maternal mental health. And it's just led by Jamie Zahlaway Belsito  who is an MMHLA founder, she used to do policy work way back before she had kids. She worked in immigration policy. And she also had postpartum depression and anxiety issues. And she's like, okay, I can take my policy experience and now married up with this new knowledge that I have. And so she led a team of advocates, came down to Capitol Hill and elevated what was the MCPAP Mom’s Program, right, which is the Psychiatry Access program. I'm guessing many people, listen to the podcast, are familiar with. But this program had started in Massachusetts, and Jamie was like, well, why don't we see if we can get federal funding so that other states can launch this kind of program? So that was the first piece of legislation. It was very small, and it was only $5 million a year for five years. I know that sounds like a lot of money, but that's really not much. So it's funded seven states initially for five years each. And so in that legislation, when it was coming to the end of its five years, we're like, okay, we need to introduce following legislation. This has been very successful. There are many other states that have these programs now, let's get more funding and let's expand it so that it's not just psychiatry access programs. Maybe there's some other things that states can do. And so, you know, over the years we have been amassing a group of advocates. And so we would, every year we hosted what we call Advocacy Day where we bring advocates together. And sometimes it's, you know, a lot of people with lived experience, but also providers in the field. We train them, we, you know, we help them tell their story and we basically knock on the doors of members of Congress. We used to do it in person, but ever since the pandemic, we've been doing it virtually. And so we sit down and have conversations with them. And, advocates tell their stories. And then we say, and here's how you can help. Right. Introduce this legislation. Sign on as a co-sponsor. Make sure this is included in the federal budget. And we have our very specific asks. And so that's how we been we have been successful in bringing this money to the field. And so we really think of ourselves as, I'll call it, the force multiplier. Like we're the ones going to Congress to say, hey, knock on the door, you need to support these programs. And then that money goes down to the states or to the National Maternal Mental Health Hotline, that's our other big program that we've been supporting. And, you know, I just want to point out, like, our organization doesn't get any of that money. We have to fundraise from other organizations, philanthropy or fundraising dollars or whatever to actually then go to Congress to do this work, to bring money to the field. 

Dr. Lara-Cinisomo [00:22:18] Yeah. Well, that's tremendous that you really are advocating for others and to, and for change, but also informing policymakers about where they can invest their resources. 

Griffen [00:22:28] Exactly, exactly. 

Dr. Lara-Cinisomo [00:22:30] Very specific asks like you said. 

Griffen [00:22:32] Yeah, yeah. So it's interesting, we are also really leaning in to support the mental health of our military mothers. We know that they are at high risk for a variety of different reasons. And so that's some new legislation that would be another five year project, a little pilot project, $5 million a year, start small right, prove it and then come back for more. That would put in place some of the evidence based programs that prevent postpartum depression. Right. Why wait to treat it if we can prevent it? And especially in the military, it's such a contained universe, right? They have their military hospitals. And so it's sort of ripe for like a pilot project like this. And so that's the legislation that we introduced this year. And hopefully we'll get funding for that. 

Dr. Lara-Cinisomo [00:23:14] Yeah. And someone like you with that lived experience of, having lived in the military environment and coming from the military, I imagine that you can speak to those issues. And, and also you have insight on into the systems at play, thinking about how and at what level you can promote and advocate for these programs. Can you tell me a little bit about how your training in the military informs the work you're doing now around postpartum mental health in the military? 

Griffen [00:23:48] Sure. So actually, you know, one of the reasons that it took me so long to get the help that I needed when I experienced postpartum depression is that when I was in the military, I was an intelligence officer. So I had very high level clearances, and I was able to maintain those clearances for a few years, when I had young children, with the thought that I would go back into that work at some point. But I also recognize and this is, you know, 20 years ago, things have changed a lot. But 20 years ago, if you acknowledge that you had mental health conditions and took any kind of medication, it could be grounds for losing your security clearance. And so I really had to struggle with this. Okay. If I take this antidepressant medication, I am in some ways saying goodbye to this part of my career. And so, you know, that was partly what took me so long to kind of, you know, bite the bullet and take antidepressant medication because I, it was a huge decision because I knew it would impact my clearance situation. And so I can talk about that. And then when I do, when I talk to people, you know, staff members on the Hill or whoever meeting with, you know, I'll explain that, that in some cases are still people's concern, right? The impact, the stigma in the military around mental health conditions. There's, we've learned a lot. We talk a lot about post-traumatic stress disorder and traumatic brain injury, particularly in the military. But these other issues, of like maternal mental health, they're, they're not, it's like a little bit softer. It's a little bit harder to understand in the military context. And so to have somebody like me who like, walked that walk and can speak about my experience is very helpful. And in fact, we, I just got off a call today with other advocates in the military space to help us figure out how do we communicate some of these things to congressional members. Right. And so we have other members of the military also joining us in this work. Yeah.

Dr. Lara-Cinisomo [00:25:39] Yeah. It's great. Once again, you're reaching out to those critical stakeholders to help move this conversation around, find solutions. 

Griffen [00:25:49] Exactly, exactly. We can't do it all. We, but we, we know who can. And so we're always bringing those people together. 

Dr. Lara-Cinisomo [00:25:55] I'd like to turn our attention to conversation around leadership. We have listeners with varied interests. What should listeners consider when thinking about leading a nonprofit organization? 

Griffen [00:26:06] Oh my gosh. So nonprofit organization. If you want to be in a nonprofit world, you have to be really passionate about what you do because there's not a lot of money there. And so in nonprofit work and I guess somewhat like in academia, it's almost like you're always fund raising, right? You're always going after the next grant to fund for work. That's sort of the same thing. Yeah. Yeah. But, you know, people in the nonprofit sector are really motivated by the issue and by their work. They're not necessarily motivated by money, which makes for a really wonderful group of people to work with. And so, you know, about leading a nonprofit, you know, you have to be able to wear many hats, right? You need to be a business person because you're, of course, always managing budgets and making sure that you have money to pay your staff. You need to be passionate about your topic. Typically at least the, the nonprofits that I have works with and for in this space are pretty small. So you have to be a good people person and navigate, you know, staffing and HR. So you really have to be a jack of all trades, in the nonprofit world, I'm guessing very much like in the academic setting. 

Dr. Lara-Cinisomo [00:27:21] Yes, we do have to manage budgets. We have labs that we have to manage with staff, whether they're paid or volunteers, whether they're students or at the professional level. So absolutely, it's like running a small center for sure. 

Griffen [00:27:34] Absolutely. Yeah. So you and I, doing the same thing. We just wear different titles. 

Dr. Lara-Cinisomo [00:27:39] Well, I appreciate you making that comparison or drawing that similarity, because the work that you're doing at the national level is really impressive. And I can imagine that there are people who are calling on you asking for your time. How do you manage your time and all the different things that you have to do in just one day? 

Griffen [00:27:59] Oh my gosh, that's a great question. How do any of us do it? You know, you prioritize, you make your list. You make your to do list. You hire good staff, right, who can take some of these things and run with them. And you give them the, the responsibility and the, you know, you sort of bless them to say, yes, you got this. Go for it. I know you can do this right. I can't do everything. I can't hold it off. Also, you know, recently I've been asked to participate in a number of advisory committees on different studies, and I'm really trying to bring more people to expand that network of people who can sit on those kinds of things, whether it's other people from our organization or really focused on lifting up women of color to make sure that there's diversity on these different committees and different advisory boards. And so I'm trying to do a little bit less of that work and trying to elevate other people to do more of it. 

Dr. Lara-Cinisomo [00:29:01] Yeah. Being kind of a broker. Yeah. For some, critical groups so that they're represented at the table as well. Yeah. Yeah, definitely important to make sure that we're advocating for different voices. 

Griffen [00:29:13] Absolutely, absolutely. 

Dr. Lara-Cinisomo [00:29:15] Yeah. So one of the other questions that I want to ask is really about going back to the starting point. You started kind of at a coordinator level, then a state, now a national. What if somebody wants to start a nonprofit, just from scratch? What are some tips you might have, some ideas? In addition, there's a 501c3, making sure that people file for those kinds of things. But what considerations should our listeners have when they're developing this idea of starting a nonprofit organization focused on perinatal mental health? 

Griffen [00:29:47] Yeah so I would say, you know, you got to think it's starting a nonprofit is you're running a small business, and the failure rate for small businesses is very, very high. And so to think very carefully about whether they want to do this and applying, and just to apply to become a 501c3 nonprofit, it's can be quite an undertaking. You gotta file with the state, you gotta file with the federal government, you’ve got to go back and forth. And so I'd also say really do a landscape analysis and see if anybody is doing this work. So for example, do you have a chapter of Postpartum Support International in your state that you can affiliate with instead of necessarily starting your own nonprofit? Is there an organization with whom you can join, and maybe do to some of this work, you because, you know, running a nonprofit is it's, it's, it's hard work. Yeah. And it is so interesting because people will come. Oh, I want to, I want to start something. I'm like, okay, well, you know, start slowly. I would say, start slowly and really see who else is doing this work. Yeah. 

Dr. Lara-Cinisomo [00:30:47] Yeah, that's a great idea about developing those organizations further that maybe you bring a different voice, maybe you have a different perspective, maybe solutions that that nonprofit or that group hasn't considered. So I that that's an important piece. Well you've been championing a number of efforts for quite some time now, and we so appreciate your work. I'm wondering, what are your hopes for perinatal well-being in the next ten years? 

Griffen [00:31:13] Oh my goodness. Well, you know what. I think they're really at this tipping point where this is an issue that is getting the attention that it deserves. When I think back about, you know, when I started, and just the number of people who are doing this work, you know, the fact that Postpartum Support International has chapters in 50 states, the fact that there's organizations like MONA and the Marcé Society and that BSD Psychiatry Access Programs in half the states, like this issue is really rolling. And I think we're all going to look back on like 2024 at some point and be like, wow, look at how much we've done. I really, you know, we think we need to take stock sometimes and say, holy cow, we've done a lot. Yes, there's still much more to be done. What I want to see before I retire is that there is universal education about maternal mental health conditions, screening for them and immediate access to resources for recovery. Right. And so I want every obstetric provider to be knowledgeable about these illnesses, whether an OB, a midwife, a nurse, whatever, whether they have a private practice or they're a federally qualified health center. Talk about these issues. It’s the most common implication of pregnancy and childbirth. We can't be afraid of it any longer. And so there would be this common conversation from the moment a woman is pregnant, or maybe even before that. Hey, these are the most common complications of pregnancy and childbirth on a screen for you. Every time I see you, I'm going to check in with you and ask how you're doing, right? And we gotta get you connected with resources as soon as possible. I think there's also got to be conversation about social determinants of health that go along with that, because we know that those issues really impact people's mental health. And that, really I think we need to change the way obstetric care is provided so that it needs to go from beyond just delivering the healthy baby to making sure the mom is healthy and happy too right, making, helping that mom transition to motherhood. And I've been thinking a lot about this recently because of the work of the National Maternal Mental Health Hotline. But I remember in my little town where I grew up, it was only about 20,000 people, and Dr. Cash was the obstetrician. He had seven daughters and he like delivered all the babies in town. And all of the moms loved Dr.Cash because he was so calm. He was this gentle man and he would really help them move through pregnancy from being a pregnant mom to becoming a mom. And I think that's what I'd like to see, you know, in the future, is that we go back to this idea of focusing on the whole person and helping each pregnant person become a parent as well. 

Dr. Lara-Cinisomo [00:34:06] Oh, what a wonderful vision. And I think we're all trying to contribute a little piece toward, seeing that fruition. And I think our listeners will be inspired before we end, is there anything you'd like to add? This has been such a great conversation about policy, how to work together, identifying your strengths so that you can really move the conversation toward perinatal well-being of the whole person, and hopefully that also the whole family. Do you have any comments you'd like to share before we end today's really interesting conversation? 

Griffen [00:34:39] Oh gosh, Sandraluz. Oh, I have so many things to share. I just really think, you know, that we have to focus, like I said, on helping women, parents transition to parenthood. Right. Like I often will make the analogy, you know, when you're pregnant, all you’re focused on is the labor and delivery. You have with birth plans. And it's all about, you know, how you want that labor and delivery to go, when actually what we really want to focus on is what comes after. When you bring the baby home and what you're going to do for the next however many months, years that you have this time, That’s sort of like when you're engaged. We are all focused on the wedding, the event, the flowers, the dress. Never mind. You get to go home and spend 50 years with this person. So I think we need to move beyond, say, the birth plans to really think about  the postpartum plan. What are we going to do when we get home? How are we, who's going to bring us food? How are we going to eat? How are we going to sleep? Right. Sleep is like the most critical thing that we can do to help new parents take care of themselves. And, you know, social media shows just all these beautiful pictures of the moms and babies, or moms and dads cuddling with the baby. And I'm like, that's not reality, right? The reality is, I was sleeping in the basement. My husband was up at the baby swap in the middle of the night. Right? It's like it's about survival. And so to make it okay for new parents to know that some of this is hard, right? But if you plan for it, you can get through it better. 

Dr. Lara-Cinisomo [00:36:07] And the plan can include a number of healthcare providers, mental health providers, community members, family, hopefully researchers who are working to get that message out. And yes, identify resources. 

Griffen [00:36:19] Yes, absolutely. 

Dr. Lara-Cinisomo [00:36:20] Important in that effort. Absolutely. Thank you so much, Adrienne for your time. We so appreciate your advocacy, the hard work you're doing, and for making time to speak with us today. 

Griffen [00:36:30] Well, thank you. And I appreciate all the work that everybody does in whatever little sphere they have to influence perinatal mental health and to make sure that our moms get off to the best start possible. So thanks for giving me the opportunity to talk with you today. 

Dr. Lara-Cinisomo [00:36:43] You're welcome. Take good care. Bye. Thank you for joining Studying Perinatal Well-being. Please see our show notes on the MONA Podcast website for more information about today's guest. We always look for great Perinatal Well-being students, community members, researchers and practitioners to interview. So please email your suggestions to 

monapodcast@marcenortham.com

That's MONA Podcast at m a r c e n o r t h a m.com. Until next time, practice compassion for yourself and others.