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Cultivating support: building mental health services that empower Black mothers

Karen R. Stewart, MD
Karen R. Stewart, MD
Chief of Behavioral Health, The Southeast Permanente Medical Group

Black women are often expected to embody the stereotype of the strong Black woman — juggling family, home, children, aging parents, and community responsibilities with ease. In fact, Black women today have unmet mental health needs, while also underutilizing mental health services. This is an outcome attributed at least in part to a perceived obligation to present strength, suppress emotions, and prioritize caregiving over self-care. This dynamic leaves many Black women and mothers feeling as though they have fallen short, and feelings of inadequacy can pave the way for depression and anxiety, which often go undetected and untreated.  

As the chief of behavioral health for The Southeast Permanente Medical Group and a Black woman who develops mental health programming for patients who look like me, I am committed to reducing the stigma surrounding mental health care for Black women and mothers. It is imperative to ensure that mental health care is readily accessible, welcoming, and effective to overcome stigma. 

Additional Challenges Facing Black Mothers 

Maternal mental health is a crucial yet often overlooked aspect of Black women’s well-being. Black women experience maternal mental health conditions, like anxiety disorders and depression, at twice the rate of all other women. Additionally, Black women may encounter a myriad of challenges that exacerbate mental health issues during pregnancy and beyond. From systemic racism to socioeconomic disparities, these stressors can be overwhelming.  

Cocoon Pregnancy Care Model  

To combat stigma and enhance access to quality mental health services, Kaiser Permanente has implemented several initiatives. In Georgia, we utilize the Cocoon Pregnancy Care Model (Cocoon Care), which places the pregnant person at the center of care and fully integrates maternal health providers including nurses, behavioral health clinicians, social workers, and case managers. As part of this model, we offer dedicated support provided by licensed clinical perinatal social workers and master’s level social workers. These providers support patients during and after pregnancy and can also help patients with social health needs, such as stable housing, healthy food access, and reliable transportation. 

Collaborative Care 

Kaiser Permanente is also committed to bringing services directly to the patient. For example, in Georgia, our primary care medical offices are staffed with behavioral health consultants and collaborative care consultants. These clinicians communicate with each other and coordinate care for the patient, creating capacity to address mental health concerns during primary care visits.  

This model, called collaborative care, adopts a population health approach to treating moderate depression or anxiety, resulting in patients achieving response or remission 50% faster than with primary care treatment as usual. This approach also reduces health disparities by offering timely treatment where and when it’s needed most. Addressing mental health issues during all care visits can help Black women and mothers feel more at ease, along with saving them the time and effort required to schedule a separate appointment with a mental health clinician. Women leave these appointments equipped with actionable skills to care for their mental health at every stage of life.  

Black maternal mental health is a multifaceted issue that demands attention and action. I am leveraging my position as a behavioral health leader at Kaiser Permanente to develop services that connect Black women and mothers with much-needed mental health care. These services must be rooted in cultural humility, accessibility, and equity. They must be services I would feel comfortable engaging in in times of need. As we strive for a future where every Black mother receives the mental health care she deserves, I am dedicated to championing inclusivity, understanding, and compassion at the heart of these efforts. 

To learn more about Black Maternal Health Week, please register for our upcoming webinar, Supporting Black Maternal Health: From Congress to Home.  


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