I would like to offer some clarification regarding an article in the May 19 issue, “Law Directs Physicians to Counsel Mothers-to-Be About Depression.”
The article concerns a new law in new Jersey that seeks to implement an initiative launched early last year by then Acting Gov. Richard Codey to educate both the public and health care professionals about postpartum depression. The law requires all licensed professionals giving antenatal and postpartum care, as well as birthing facilities, to provide to pregnant women and their families “as appropriate. .complete information about postpartum depression, including its symptoms, methods of coping with the illness, and treatment resources.” To this end, screening is mandated“ prior to discharge from the birthing facility and at the first few postnatal checkup visits.”
Some colleagues have questioned the role of New Jersey psychiatrists in this initiative and expressed concern about possible sanctions that may apply to physicians and nurses who fail to follow the new law.
Psychiatrists participated in developing a PowerPoint presentation, as members of the Subcommittee for Professional Education of the original Work Group on Postpartum Depression appointed by the governor. I served on that subcommittee, which was chaired by Ricardo Fernandez, M.D., a fellow member of the New Jersey Psychiatric Association, along with several obstetricians, obstetrical nurses, a pediatrician, and psychologist. The educational program, to which we gave the title Perinatal Mood Disorders, may be adapted for use with professional education credit by psychiatrists, other physicians, and health care workers. It is posted on a New Jersey state Web site,<www.njspeakup.gov>. The recommended screening tool is the Edinburgh Postnatal Depression Scale. Several regional symposia have been conducted to train additional professionals, including psychiatrists, to disseminate the program as widely as possible.
At this time, policies and procedures are being developed by the New Jersey Department of Health and Senior Services in conjunction with the Board of Medical Examiners and the New Jersey Board of Nursing, which are expected to work with health care facilities and licensed health care professionals in the state to achieve the requirements of the law. It is quite possible, whether or not there is genuine consultation with service providers, that sanctions may be imposed for noncompliance, though I and others have expressed concern that sanctions may constitute an unfair hardship unless there is mandated payment (from the state or private insurance companies) to cover the extra professional time required for regular screening and education of patients and their families.
