April 16, 2015. Seleni Perinatal Workshop and BK FamilyFriends Rally at Borough Hall, Brooklyn. Attendance by Brooklyn Borough President Eric Adams and Seleni Institue founder, Rebecca Benghiat. Photography by Margarita Corporan

2017 Hope and Grace Fund Grant Recipient: Seleni Institute

May 4, 2017

The month of May continues with our spotlight focus on this year’s hope & grace fund recipients. This illustrative list of community leaders and initiatives make great strides in the field of mental health every day, shining a light and improving lives. We’re proud to assist them in their goals and are proud to announce that this round of grant recipients brings our total grants to over 3 million dollars in just three short years. It’s our honor to help these initiatives pave the way to a brighter future for mental health. 

Today’s spotlight is on The Seleni Institute, and Chief of Staff Rebecca Benghiat sat down to talk a bit more about this amazing organization, what it does, and how it improves the lives of women who need assistance with perinatal mental health care:

 

“We are an organization devoted to the mental health and wellbeing of mothers and families. Our philosophy is that children in families do better when their parents are doing better. To that end, we work diligently to address issues before they become a problem.

We accomplish this mission in a variety of ways. First, we have a clinical practice at our headquarters in Manhattan where we see about 300 patients a week, talking about issues ranging from infertility support; anxiety and depression before, during, and after pregnancy; to grief and bereavement, which is a significant part of our clinical practice covering miscarriage, stillbirth, and child loss. We also offer a lot of parenting support work, from general needs to working with parents of children with special needs. We also see pregnant and parenting adolescents ages 14-22 for free. We work with couples, fathers, mothers —anyone connected to the child in question. Our clinic offers financial assistance on a sliding scale and we’re in network with some insurance providers with the idea being that our services should be as broadly acceptable as possible.

Second, we have our editorial program, which addresses all the same topics that we address clinically but online. Our goal is to offer our information as non-judgmentally as possible, working to meet readers where they are along with providing evidence-based advice and support. Through this, we also have a small research funding program to support mental health research. We know there’s not enough support for this crucial type of work.

Third, Seleni Institute offers our training programs, which in some ways are our largest offerings. We know that our clinical practice can only reach a certain number of folks, so it’s important to us to increase access to quality mental health care along with training professionals who deal with our population on how to conduct appropriate screening, an issue we know isn’t happening right now in any significant way between providers and pregnant women. We have two different training offerings, general training to teach any professional who encounters a pregnant woman up to the first year how to screen them for mental health issues and then how to refer them out if they discover a problem. We provide this training for obstetricians, midwives, doulas, social workers, etc. A lot of them won’t screen because they don’t know how to ask the questions and/or they’re afraid they won’t know what to do if they discover that someone isn’t doing well. So, we walk them through all the permutations: what could possibly happen, and then what to do.

Our other training is to teach mental health care providers how to work with the perinatal population, which includes both pregnant women and post-partum women. Often, mental health providers are concerned about working with a perinatal population because they’re afraid of doing harm or they think the issues will be completely foreign to what they’ve learned. Clinical training programs, especially in the US, don’t address perinatal mental health at all, and the only aspect of it that gets any training at all is reproductive psychiatry. So, the secret that’s not-so-secret is that depression is depression, anxiety is anxiety, and the perinatal population is no different than the general one. We teach them to use the skills they should work with these populations that already exist in their community and practices without fearfully referring them out before they’ve been given a chance.

This type of training is critical. Let’s take the example of intrusive thinking. If you’ve ever been on a tall building, there might be a split-second thought that crosses your mind where you think you might jump. You have no intention of jumping; that’s just your brain testing all the permutations of the bad things that could happen to you that aren’t going to happen because you’re keeping yourself safe. Now, let’s say you’re a new mother. You think you might drop it or smother it – all these things spin through their heads. Where most of us brush it off, sometimes pregnant women take it on with such great fear and judgment, that they must be a terrible mother. The thought keeps reappearing, and suddenly they find themselves launched into Obsessive Compulsive Disorder, particularly if they’re already predisposed to anxiety.  They panic, they can’t rest, they’re horrified by their own thoughts. Clearly, if you’re not disturbed by this thought, we’re talking about psychosis and that requires intervention, but 80% of new parents have intrusive thoughts around their baby, and most of it is completely harmless.

If they’re seeing a professional without our training, the admission of an intrusive thought might cause a therapist or medical professional to call Child Protective Services. Our training is different and helps them understand that the very idea that the mother is distressed by her thought is good because it means she’s not going to act on the thought. We explain how to coach the mother through these thoughts and offer interventions to make it less scary, like cognitive behavioral therapy. So, if you’re not upset by your distressing thought, we’re talking about psychosis. That’s a fundamental example of some of the training we do for practitioners.

We’re proud to work with hope & grace fund to provide an expansion of our Maternal Mental Health Intensive (MMHI) program to one specifically designed to address the needs of adolescent mothers, a program we’re calling MMHI4teens. We’ve recognized that there’s a lot of conversation around pregnancy prevention and reproductive health with adolescent girls, but not a conversation about mental health and adolescent pregnancy. This is a huge issue considering teens with mental health issues get pregnant at three times the rate as those without. Also, 50% of adolescents experience post-partum depression, which is about two-to-three times of that of older mothers. There’s this dual stigma of being a teen parent in addition to having a mental health issue, that not only are they dealing with depression and mental health issues but also the stigma that because they got pregnant so young that they deserve to feel poorly. Our program goal will be to train professional service providers that work specifically with this population on perinatal mental health issues with specific considerations for the teen population. We’ve offered four in-house sessions this year, and plan to offer eight additional pieces of training in partnership with organizations that already serve this population. We’re already in conversation with city agencies and other Community-Based Organizations (CBOs) – housing CBOs, education CBOs, etc., which will allow us to provide the training to their professionals onsite for free. It also ensures the benefits of our programs are felt outside the walls of our offices. We’re based on the Upper East Side of Manhattan, and if you’re nine months pregnant and living in the Bronx, it’s hard to get to us. This ensures that the people who need our program benefits can receive them through their health care providers and service providers in their own area.

It’s important to note the staggering numbers that drive our efforts. Although the pregnancy rate has fallen significantly (61% from 1991-2015 due to long-acting contraception such as IUDs and other contraceptive implants, not abortion,) the birth rate for young women with mental illness has not. In New York City alone, that translates to about 10,000 adolescent pregnancies a year.

Stigma with the adolescent mother population runs deep, and it affects their care. We know from moms who had a child in their teens who then later had children as adults that they were only aggressively treated for postpartum once they were adults. It’s also important to help this population work through their mental health diagnosis and stigma so they can get the resources they need. It’s hard to access social services and educational opportunities when your mental health is compromised. We tell these young mothers to go get their GED and get a job or go find childcare, but it’s difficult to accomplish anything if you’re suffering from depression or anxiety. We can’t expect these moms to accomplish what we’re asking them to if we don’t first secure this as a very basic health issue. I think that’s where we want to enter the conversation beyond the reproductive health conversation.

One of our goals for this year is to take this training outside New York. We didn’t quite comprehend the interest in this, but it’s clear to us that our program benefits are needed everywhere, that the need is wide-sweeping.

If you want to learn more about us or know someone who might need our help, you can find us through our website, which also includes our phone number. We also have a very good database to make sure that if we’re not the right service provider to help you and/or if you live outside our service area, we’ll work with you to help you find the help you need.”