Mental health care is maternal health care at the Health Annex by Mary Cerulli

It might take a village to raise a child, but it takes a team of providers to support a pregnant woman too. When I introduce myself to patients, I tell them I am the prenatal patient advocate, one member of their prenatal care team. My role is to connect pregnant patients at the Health Annex to health insurance, to resource programs to support them, and to the other prenatal care team members. At the Health Annex, prenatal care is a group effort. The clinicians, obstetricians and midwives, are responsible for determining the medical needs of patients and managing their health conditions. The medical assistant runs tests, acquires results, schedules off-site care, facilitates the sharing of medical records, and manages the flow of patients. Meanwhile, the prenatal nurse wears the hats of health educator, care coordinator, and confidant.

In addition to asking patients whether I can help them with insurance enrollment or resources like WIC, a healthy food vouchers program, Nurse Family Partnership, a nurse home-visit service for first-time moms, or Healthy Start, an umbrella organization for many different education and support programs for parents and children, I also administer mental health screeners. The Adverse Childhood Events Survey is used to assess traumatic events experienced up through the age of eighteen, and the Edinburgh Postnatal Depression Survey is used to assess feelings of depression in the previous seven days. Both of these screeners are important tools for the behavioral health consultants, the mental health providers of the prenatal care team. Research, some of which was conducted at the Health Annex, shows that the experience of traumatic events impacts health outcomes. And the Edinburgh survey, in addition to addressing feelings of depression in and of themselves, is a tool to diagnose postpartum depression, which often goes unreported or undetected. The behavioral health consultants’ role of providing mental health counseling and support to every prenatal patient is one aspect of the Health Annex’s effort to be a trauma-informed health center. By acknowledging mental health care as integral to primary care, the Health Annex is a place where patients are also people.

When I started in my role as a prenatal patient advocate with NHC Philly, I gained an understanding of the importance of social work in providing patient-centered and socially relevant health care. Behavioral health consultants are an essential part of the primary care team at the Health Annex. I have seen the way that integrating mental health care and patient-specific coping strategies into individual care plans and health center services increases the accessibility and quality of care. Speaking with the behavioral health consultants at the Health Annex and observing their role in the prenatal care team clarified my search for where I myself fit in health care. It’s thanks to my experience with NHC Philly that I am applying to Masters in Social Work programs and feel like I finally know what kind of professional I want to be.