Redleaf Center provides resources for improving the mental health of parents

CATHY WURZER: Here's an understatement, becoming a mom is not easy. And that's especially true in this country. Among wealthy nations, the US has the highest rate of maternal mortality, which is defined as a death during pregnancy or up to a year afterward. Common causes include excessive bleeding, infection, heart disease, suicide, and drug overdose. A recent study from the Journal of the American Medical Association found that that tragedy also unfolds unequally, with Black mothers dying at the nation's highest rates. The CDC reports 1 in 8 women deal with postpartum depression, but many moms have nowhere to turn.

The Policy Center for Maternal Mental Health gave the US a grade of D, saying the country is failing to support mothers during and after pregnancy. Minnesota is not much better, receiving a D plus. But a local clinic is trying to change that. It's the Redleaf Center for Family Healing and was Minnesota's first intensive mental health program for pregnant and postpartum mothers. Joining us is the founder, Dr. Helen Kim. Dr. Kim, welcome.

Thank you, Cathy. Thanks so much.

My gosh, postpartum depression has been around for, what, hundreds of years. It used to be called the baby blues. What do we know about it?

Right. I think it's important, the language has really evolved. And I think people's shared understanding has evolved. The postpartum blues is actually not a pathological condition, it occurs in 8 out of 10 birthing and postpartum people. And so it's a non-pathologic condition, it's time limited. It usually doesn't extend beyond 7 to 10 days after delivery. Postpartum depression is a depression that persists beyond that and includes overwhelming low mood, lack of interest, low energy, et cetera.

So I think the public has focused on postpartum depression. And I think there's been this growing awareness that many situations where people have postpartum depression actually began prenatally. And so the new framing is perinatal, meaning during pregnancy, or postpartum, in the first year or more after delivery. Perinatal mood and anxiety conditions or maternal mental health conditions, I think, is the most succinct way to say it. I think it's important to let people know that it might not be depression that resonates with you. It might be more anxiety, or irritability, or difficulty sleeping. And so I think it's not only depression that people experience.

Can you explain what's going on? Is it all the hormones, the stew of hormones that occurs when you are pregnant that is the spark for some of this?

I think that's such an important question. I think that's the-- intuitively, what people wonder about is the biological and hormonal changes that happen in the transition from pregnancy to postpartum. And that is one contribution to vulnerability for more emotional distress. I think the other important contributors though are things like the psychological and identity shifts that happen, the social stressors that happen, and early life trauma, family history, et cetera.

And importantly, what you're naming too about the United States, I think, is crucial, which is that we live in a culture that does not support families as they're expecting a baby or parenting babies or young children. And so some of the distress that people feel isn't hormonally driven, it's actually driven by the toxic environment that we live in, where childcare is not affordable for many families or accessible, where health care isn't a given for many families. So there are these toxic environmental exposures that, as a human, you'll have a response to, which includes that fight, flight, freeze, high-anxiety state, et cetera. It's something that I often name with patients.

A phrase that Shawn Ginwright uses is called PTSE, which is Persistent Toxic Stress Environment, that often, the families that we see are struggling with perinatal mood and anxiety conditions and also what we call PTSE, Persistent Toxic Stress environments, that they're having a human response to the scarcity that they're living in.

And again, I think it's important to name both. Because often, the mothers that we meet feel very ashamed that they're somehow failing themselves, and their families, and their children and that they own all the responsibility for their struggle. And so what we try to do is to really broaden the lens so that they can see the bigger context, which is that mothers are not supported in the United States in ways that are very unusual in other developed countries. And not surprisingly, mothers therefore struggle.

And should we also say that fathers struggle too with becoming a parent?

Definitely. So there have been studies of paternal mental health. And we know that 1 out of 10 fathers, for instance, struggles with depression. We know that fathers often may present with irritability, anxiety, low mood, et cetera, as well. I think it's a very underfocused-upon area, which is paternal mental health. And I will say there is a large population that we serve that the mother might be the identified patient in the family system, but often, one of the things that she's responding to is the distress in her partner. So I think that's really important to name.

What services does the center provide for patients?

So the Redleaf Center actually grew out of, first, a Hennepin women's mental health program, based at Hennepin Healthcare system, where we focused on mothers with depression and anxiety during and after pregnancy. And over time, we recognized that it was not only an individual crisis, but it was a relational crisis that mothers were struggling with their relationships with themselves, their babies and children, and their partners. And so we broadened the lens and launched the Mother-Baby program in 2013. And then we broadened it again to call it the Redleaf Center for Family Healing, which acknowledges that it's a family event, that when mothers struggle, they do it in the context of their family. And often, as you're saying, fathers and partners are struggling. And that it's not just an individual experience, it's actually a relational and a family experience. So the Redleaf Center, our focus is on families planning or expecting a baby or parenting young children, we say 0 to 5 children. And that reflects that developmental brain development window where children are completely reliant on caregivers and also a time when mothers and fathers continue to struggle. So we focus on that population, and we provide high-quality mental health and parenting support.

That includes also a holistic view of mental health. We know that the mind is not just in the brain, the mind is also in the body. So this idea of whole body mental health, which is a phrase from a British psychologist, Kimberley Wilson, this idea that it's not only what we're thinking that affects our mood, but it's also how we eat, our environmental experiences, our relational experiences, all of that are contributants to distress and also pathways to healing.

So we have a teaching kitchen that really is focused on the power of food, not only the preparation of food and the sharing of food, but also just the practical parts of eating together, which is, I think, such an important ritual, I think, that we, in our busy lifestyles, we often bypass those simple things of family meals and communal dinners. So we have a teaching kitchen. We have space for integrative mind-body interventions and an area that's more child-centered, focused on infant and early children who are struggling with attachment and other forms of emotional distress.

And then our core program is the Mother-Baby program, which is mainly group-based therapy and includes a reproductive psychiatry clinic and a reproductive psychiatry resident training clinic. And recently, we also have been welcoming therapy interns. So we really want to grow the workforce capacity in Minnesota to look through this multi-generational holistic lens at perinatal mood and anxieties by really building that workforce with training opportunities.

That's a lot. Dr. Kim, I appreciate your time. Thank you so much.

Thank you.

Dr. Helen Kim is the founder of the Redleaf Center for Family Healing. Now, if you need help, the center has a helpline. You can call this number, 612-873-HOPE, H-O-P-E. For immediate help you can also reach the National Suicide and Crisis Lifeline by calling or texting 988.