Screening and Treatment for Maternal Depression and Related Behavioral Disorders Program - Michigan Clinical Consultation and Care Maternal CARES: Consultation, Access, Referral, Education, and Screening (MC3 Maternal CARES) will expand Michigan’s existing MC3 perinatal psychiatry access program to improve care for pregnant and postpartum women with mental health and substance use needs in rural, underserved areas. The project will focus on 16 Michigan counties with shortages of health professionals and limited access to maternal mental health and substance use disorder services: Arenac, Bay, Clare, Gladwin, Isabella, Lake, Mason, Mecosta, Midland, Missaukee, Muskegon, Newaygo, Oceana, Ogemaw, Osceola, and Roscommon. Mental health and substance use conditions during pregnancy and the year after birth are common and can have serious effects on mothers, infants, and families when they are not identified and treated early. In Michigan, substance use is a leading contributor to pregnancy-associated deaths, and many deaths occur after delivery. Rural communities often face added barriers, including fewer mental health and substance use providers, long wait times, transportation challenges, and limited access to specialists with expertise in pregnancy and postpartum care. MC3 Maternal CARES will help address these gaps by supporting the providers who already care for pregnant and postpartum women, including obstetricians, family physicians, primary care providers, nurse practitioners, physician assistants, and certified nurse midwives. Through MC3, providers will have same-day access to perinatal psychiatric consultation for questions about screening results, diagnosis, medication use during pregnancy or breastfeeding, treatment planning, substance use concerns, safety planning, and referrals. The project will also expand care coordination and help providers connect patients to mental health treatment, substance use disorder services, crisis supports, telehealth options, peer recovery support, self-help tools, and community resources such as transportation, food, housing, childcare, and domestic violence services. The project will build on existing partnerships among the Michigan Department of Health and Human Services, Michigan Public Health Institute, and the University of Michigan MC3 program. It will use established MC3 infrastructure allowing funds to directly expand services in high-need rural communities. MC3 Maternal CARES will also develop and maintain an updated referral database with local and virtual resources, including information on eligibility, insurance accepted, language availability, telehealth options, and services available for pregnant and postpartum women. Over the project period, MC3 Maternal CARES will enroll at least 100 maternal health providers in the target region, provide at least 300 psychiatric consultation and care coordination episodes, train at least 300 providers, and identify and verify at least 100 community-based resources. Training will focus on practical, evidence-based approaches to screening, brief intervention, treatment, referral, follow-up, trauma-informed care, and respectful care for women with depression, anxiety, trauma symptoms, opioid use disorder, alcohol use, and other substance use concerns. By strengthening the providers who serve pregnant and postpartum women, MC3 Maternal CARES will make it easier for women in rural Michigan to receive timely, appropriate, and coordinated care close to home. The project is expected to improve early identification of maternal mental health and substance use needs, support safer and more effective treatment planning, reduce avoidable crises and emergency department use, and improve outcomes for mothers, infants, and families.
