I am not currently providing Maternal Mental Health (MMH) Screening consultation services to the organizations that I intended to. I do not have contracts with large healthcare organizations, I do not have advocates in Obstetrics or Midwifery who are taking my mission to their leadership, I do not have a brick-and-mortar office, and everyday is a fight to be heard, seen, and believed within the ecosystem that is MMH. 

What I am doing is providing MMH Screening consultation services to organizations I could never have imagined would be interested. There are nine (9!) nonprofit organizations who are implementing the Ingram Screening business model currently. These organizations serve families with children ages 0-3, the parents are NOT their primary clients/patients, the children are. These are programs who recognize the mother-baby dyad and that parental mental health is crucial for Infant Mental Health (IMH) and they want to provide the best possible start for these families. 

Grassroots screening is not what I had planned.

I assumed that a top-down trickle effect from providers and organizations that serve pregnant and birthing people would be a natural trajectory in getting people screened and offering resources,  and that was a wrong assumption. The healthcare system in the United States is a mess, it’s rigid and hard to penetrate without money (venture capital), access, and a solid plan of ROI for the institution. The humanity of the suffering parent takes a back seat.

Protocol over humanity, got it. 

Would you like to know WHO is implementing the Ingram Screening business Model?

Hospital to Home (H2H) Programs

Family Resource Coordinators (FRCs)

Community Health Workers (CHWs)

Infant Mental Health (IMH) Specialists

Neonatal Intensive Care Unit (NICU) teams

Family Services Navigators (FSN)

Early Support of Infants and Toddlers (ESIT)

Women Infant & Children (WIC)  

This is where grassroots mental health screening is happening, at small nonprofits meant to serve the child. These organizations are not billing private insurance or Medicaid for screening, they are not charging parents for screening, nor are they concerned with ICD-10 codes for diagnostic purposes. Do you know what they are concerned about? Having conversations with the parents in their care, recognizing suffering, offering compassionate care, and providing free resources and education on MMH disorders. They are choosing humanity and showing parents how to receive help regardless of any ROI to their organization other than providing Total Quality Care (TQC). 

At the intersection of humanity and protocol is the Ingram Screening Policy and Procedure Manual/Screening Workflow that teams create for their own organization as the last step in implementing screening. This is where they lay out their process for screening and list what they pledge to do; the top six suggested pledges are below and include the screening tool of their choosing. 

We pledge:

1. To remind all parents that screening is part of regular programmatic procedures not based on a perceived need.  Screening is offered to all Caregivers (birthing, non-birthing, adopted, foster, etc.). Screening is not mandatory, and Caregivers have the right to refuse to screen.

2. To communicate that screening is not diagnostic, it is an assessment tool that will lead to a discussion about the internal and external sources of support available.

3. To offer all clients referred to (ORGANIZATION), screening services for perinatal mental health issues during their initial evaluation and at intervals outlined in this document.

4. To administer screenings using an approved and validated tool, the Edinburgh Postnatal Depression Scale (EPDS), following the recommended screening frequencies.

5. To administer the screening tool, EPDS, in such a way that a parent is afforded maximum privacy. The screening tool is expected to be filled out without a partner present for 

maximum validity.  If the tool is completed with another person in the room (partner, interpreter, etc.), it will be noted.

6. To administer the EPDS in culturally appropriate languages whenever possible to mitigate the need for a parent to conceal their true experience with an interpreter.

I no longer aspire to start at the top and let my knowledge trickle down to those in need. I am starting with those in need and working from the bottom up. 

Humanity over protocol, got it! 

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