Counselor Advocacy with Maternal Mental Healthcare

Christa Butler:

Welcome to the Voice of Counseling from the American Counseling Association. Thank you so much for tuning in to another episode of Seasons two, the Voice of Counseling Podcast. I'm Christa Butler from ACA and joining us today at Shivonne Odom, who is here today to speak with us on the crisis with maternal mental health care and how counselors can advocate for needed changes in this area. Before starting our discussion, we want to share with our listeners that the new Wiley Online Library app is now available. This new app will keep you connected with the latest research in JCD, as well as other journals in the Wiley Online Library that you have a subscription to, including the Career Development Quarterly, Counselor Education and Supervision, Journal of Addictions and Offender Counseling, Journal of Employment Counseling, the Journal of Humanistic Counseling and the Journal of Multicultural Counseling and Development.

Download the app today in your Apple or your Android store. Shivonne Odom is a Licensed Professional Counselor in Washington, DC, a National Certified Counselor and a Licensed Clinical Professional Counselor in Maryland. She is also a National Certified Perinatal Mental Health therapist by Postpartum Support International and a board-approved clinical supervisor. She's the owner of Akoma Counseling Concept LLC located in Washington, DC. Shivonne is passionate about helping to improve the mental health of women by promoting women's empowerment and mental health awareness. Shivonne graduated from Howard University with her master's degree in counseling psychology. She completed her postgraduate certificate training in maternal mental health counseling via the Postpartum Support International and the Mary Center Clinic, DCPMH Champions Project in Washington, DC. Shivonne thank you so much for joining us today.

Dr. Shivonne Odom:

Thank you.

Christa Butler:

Let's hop right into our discussion. What is a perinatal mental health therapist? And can you share with us a little more about your journey towards specializing as a perinatal mental health therapist?

Dr. Shivonne Odom:

I first began my interest in perinatal mental health counseling when I worked in a behavioral health integration team at a federally qualified healthcare clinic in Washington DC. And it was the first time I got to see patients as part of their physical exams, their women's wellness visits, their prenatal visits by providing postpartum depression screens and depression screens, a PHQ-9, a patient health questionnaire-9. And I was just fascinated. I was fascinated and I really enjoyed working with this population and I also enjoyed seeing the growing families. And so that's really where I got my introduction to it. And so I just engulfed myself in a world of perinatal mental health training, and that's really where my passion began. And I saw that there was not that many perinatal mental health clinicians of color and private practice and surprisingly in DC. And so I said, "Okay, well, let's do it. Let's create a practice focused on perinatal mental health disorders."

And pretty much to explain your questions. We answer your question, what is the difference between a perinatal mental health clinician and a clinician that is not trained in perinatal mood anxiety disorders? So a perinatal mental health clinician is somebody that has taken extensive postgraduate education in perinatal mood anxiety disorders through organizations like the Seleni Institute in New York or the Postpartum Support International or Caring Clymans Postpartum Stress Center. And those are just some organizations. I also provide continual education on black maternal mental health in the black maternal health crisis as well. But it's a series of training. And you also, I want to stress, that is that you also should be participating in some type of clinical supervision that is led by a clinical supervisor that has been certified in perinatal mental health counseling, or they have taken enough coursework where they could be eligible to be a PMH-C, a board perinatal mental health clinician, board-certified perinatal mental health clinician.

Thank you so much for sharing that. So it sounds like it is a combination of training, supervision, and ongoing education and experience in the field in terms of being qualified as a specialized perinatal mental health therapist.

Yes, yes. Because even now I'm about to attend I think, my third or fourth post-partum support international conference, the learning just never ends. And I mean, especially with the pandemic just happening, there's been a lot of changes and trends in more awareness.

Christa Butler:

Absolutely. And that's a great segue into our next question, which is the COVID 19 pandemic has exacerbated gaps in services with maternal healthcare and maternal mental healthcare. Can you share with us, how do we get here? What are some of those factors that are contributing to this crisis that we're seeing in maternal mental health?

Dr. Shivonne Odom:

Prior to COVID, when I received my perinatal mental health training, there was a big emphasis on social support, community support. In 2020, we were in this long term quarantine. So we weren't allowed to have social support and community support. Having that social and community support might have unfortunately resulted in death. And so we had a lot of parents that became parents with minimal to no social support or family support. And unfortunately in the beginning of the pandemic, I had some clients who really, they had really become invested in their prenatal care and some of their birth centers had closed down. And sometimes, unfortunately practitioners, they get sick. And sometimes, unfortunately before the vaccine, people were passing away. So all of those things impacted care. And so we saw an increase in maternal mental health disorders. Again, we're seeing a rise for some individuals having to work from home and having to balance childcare while at home and working at the same time.

Some people losing employment while becoming a parent, some people who are going through fertility treatments, having to deposit their fertility treatments because the clinic was closed and then having to start up later, that can cause a lot of stress for somebody because as you know, as women, as we get older, sometimes our egg count can decrease and the equality of our eggs sometimes can increase. So all of those things created this storm of anxiety and depression. And also as I hear from some of my clients that were single, dating, they were just like, "How can I even date and let alone even talk about having a family and I can't go outside." And so all those different factors are contributing to what we're seeing in this increased in maternal mental health slash perinatal mental health disorders, maternal mental health and perinatal mental health disorders are the same. I just use the terms interchangeably. And so those are the different factors, access to care, health insurance. Some people experienced a lapse in health insurance in the pandemic. And so those are other factors as well.

Christa Butler:

So social determinants to health is impacting what we're seeing today. Some of these things were preexisting, many of them were preexisting and they'd been exacerbated by the impact of COVID, the loss of jobs, the loss of access to some services that may have been available but are now a little bit more harder to reach.

Dr. Shivonne Odom:

Yes. And then also thankfully ACA is working on the compact and that's another thing too, accessibility. So during the pandemic, I received an increase from individuals from different states requesting perinatal mental health services because unfortunately, perinatal mental health is still a small field. And so it's not like you can just go and find one in your town, there may not be one in your town. And so access is just, it's minimal. And so because of lack of reciprocity and licensure, I can only provide therapy to individuals that are in the jurisdiction for where I'm licensed, which is DC and in Maryland.

Christa Butler:

Absolutely. And so, as you mentioned, the Counseling Compact, as long as it's in a participating state, it definitely is a solution to providing services to those who may not have otherwise been able to access them very easily. How can counselors best serve black individuals, people of color and individuals of low income, who are disproportionately being impacted by maternal mental health inequities?

Dr. Shivonne Odom:

I'm glad that you asked that question. So maternal mental health is not just a socioeconomic status issue, especially when we're talking about the African American community. We have to address the isms. We have to address the -essions, the microaggressions. Maternal mental health does not discriminate based on socioeconomic status. One of the things, the common questions that I get is, hey, I've had individuals come to me and say, "I serve low income African American individuals. So I would like to consult with you." Well at Akoma Counseling Concepts and having been a very proud Howard alumna, I understand that all of our individuals need access to care. And so one of the biggest barriers is insurance. So I accept at least one private insurance. And I also accept at least one type of Medicaid because unfortunately there are individuals that do have private insurance, but it's just not in their budget to pay 200 and $250 per session for a therapy session.

And also my access to my referral base of doulas, lactation counselors, midwives and nurse practitioners, it really should be available to all of us. And so therefore some of the resources that my clients that have Medicaid have access to, some of my clients with private insurance don't. So for example, I in network with a DC Medicaid. And so my clients that have DC Medicaid, they get access to free meal delivery and car seats and safe sleep classes. And they can be able to find doulas that are networked with their insurance, which is why I accept DC Medicaid, but my private insurance, they don't have those benefits. They don't have those perks. And so DC, unfortunately, has the 10th highest black maternal mortality rate in the country. So when we only focus on one segment of a whole population, we are still missing a whole lot of other mommies out there that could still be alive.

And so I want to make sure that we are aware that race is not equivalent to socioeconomic status and that when we are addressing only one segment of African American women, we're still ignoring whole other populations of women. Think of the clinicians that are in private practice, that are business owners that go through large, long time gaps where they're uninsured, because sometimes it can cost as much as four to $500 a month to have insurance and you're pregnant and you're managing that. Those are also populations that are not addressed or again advanced maternal age moms, moms that are 40 years old and or 36 years old and older. They also have significant needs that are not being addressed. And so I want to make sure that, that's another reason why I do this work, that we're not saying that only one certain population of African American moms need services, because there's a lot of funding that goes towards that. And a lot of the rest of the African American female population is missed. It's missed.

Christa Butler:

Absolutely. And it is clear that this is a much needed area of advocacy for counselors and for mental health professionals and for healthcare professionals as well, of course. And so I'm curious, what do you think that counselors can do for needed changes in both maternal mental healthcare and maternal healthcare? What can counselors do to advocate for these changes?

Dr. Shivonne Odom:

More of us need to begin to start accepting at least one form of insurance, that's number one because I noticed that you leaned in with Medicaid. If we can address Medicaid, then we also need to say that, "Hey, we need to accept at least one form of private insurance, One." The other thing that we can also do to advocate for that as perinatal mental clinicians, make sure that we establish professional relationships with local graduate institutions to be able to host graduate student interns so we can train them in perinatal mood and anxiety disorders. I have a professional relationship with at least three local graduate programs. And so I have supervised graduate student interns and I have successfully supervised two licensure, three black perinatal mental health clinicians.

And so that's one of the things we can do to advocate is actually being of direct service to actually again, create the number of perinatal mental health clinicians available. So we can counsel, but we can also supervise, we can supervise graduate student interns. We can also attend some postgraduate perinatal mental health clinicians. A lot of the training that I received in the beginning, my job fortunately reimbursed me for some of that training. So we can advocate if we get the education, because if we don't know, then what do we know how to advocate for, but also take advantage and participate in any local legislative events pertaining to passing bills or legislation surrounding maternal mental healthcare.

Christa Butler:

For counselors who are interested in seeking additional training and or specializing in perinatal mental health, what suggestions do you have for what they can do to meet this goal? Where can they find additional trainings and additional opportunity to increase their skills and to increase their knowledge in this area?

Dr. Shivonne Odom:

Sure. So as I mentioned earlier, they can definitely take online or in person continuing education trainings via Postpartum Support International that is who has created the PMH-C, the National Perinatal Mental Health Clinician credential. You do have to take a certification exam in order to get that credential. They can also go to the Postpartum Support International Conference. They're having one in New Orleans in July of this year. And I'm so excited about that conference. I love going to their conferences because there, they also share about even more learning opportunities, even more continuing education opportunities.

And then of course, the Seleni Institute in New York and the Postpartum Stress Center and 2020 Mom and Maternal Mental Health Now, Maternal Mental Health Now always has some type of great training, whether it's for three CEs or two, and then also Mass General Hospital, MGH. MGH is a women's perinatal psychiatry department. They have some great, great, great trainings and they also have rounds. So every week, once a week, it's free it's for an hour, you can call in or you can log in via Zoom and you can do a case presentation and get a consultation from perinatal psychiatrists and perinatal psychologists and other perinatal clinicians from around the country.

Christa Butler:

Awesome. Thank you so much for sharing all of those resources. Is there anything else you'd like to share with our listeners on maternal mental healthcare?

Dr. Shivonne Odom:

Do not be afraid to refer your clients to perinatal mental health clinicians. It's important that if your client is exhibiting any symptoms of postpartum depression, postpartum anxiety, postpartum PTSD, or postpartum psychosis, that you refer them to the appropriate clinicians because unfortunately some symptoms of perinatal mental health disorders can mask other disorders. And so what happens is we can retraumatize our clients and potentially make them interface with systems that they really should not be interfacing with because we have not received the training that we should have. And so that's one of the barriers to care. When serving the black perinatal mental health clinician, as many people are scared that clinicians are going to call child protective services or send them to interface with some systems when they may not need to. And so when you see the right clinicians, then we're able to put in the right care. And a lot of times it's not just me seeing my clients, it's myself, and a wealth of other wonderful support birth workers.

Christa Butler:

Thank you so much for sharing that information. Shivonne. Where can our listeners find you if they'd like to reach out and like to connect with you?

Dr. Shivonne Odom:

Counselors can find me on Instagram at Akoma_Counseling, A-K-O-M as in mother, A as in apple underscore counseling and on Twitter @Akoma Counseling and on Facebook, Akoma Counseling Concepts LLC. And they can kindly visit my website, www.akomacounselingconcepts.com.

Christa Butler:

Thank you so much. Shivonne thank you again for joining us today on the Voice of Counseling, it has been an honor to interview you and to learn from you. Thank you for all that you do in serving clients in the area of maternal mental healthcare.

Speaker 3:

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