Postpartum depression focus for several Mass. bills after Clancy case

BOSTON — In the wake of the recent tragic events in Duxbury, a renewed effort is underway on Beacon Hill to expand and increase access to perinatal mental health care.

“This is the right time to be able to work with (this commission) to get a lot done and save (the) lives of moms and birthing people and babies,” said state Sen. Liz Miranda, D-Boston, a member of the Ellen Story Commission on Postpartum Depression, during the group’s meeting last week.

Lindsay Clancy, a 32-year-old mother of three from Duxbury, was charged last month with killing her young children before trying to take her own life. During her arraignment, Clancy’s defense attorney, Kevin Reddington, argued she had been overmedicated after giving birth to her youngest son, an 8-month-old, and may have been suffering from postpartum depression and psychosis.

“In light of recent events, there has been renewed interest in the legislation on a number of fronts and, I would say, a collective feeling of urgency around the question of how we as a society should not only understand and respond to perinatal psychiatric complications, but also how can we identify these and prevent them from arising,” said Ashley Healy, a lawyer who serves as coordinator of the commission.

A special legislative commission was established in 2010 in Massachusetts to study and report on research and policy initiatives on postpartum depression and to make recommendations to address it. In 2016, it was named for retiring state Rep. Ellen Story, D-Amherst, who had championed legislation pushing for increased education and resources for postpartum depression.

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A recent bill addressing such matters is a revised version of one filed last legislative session by Rep. Jim O’Day, D-West Boylston, that would require criminal defendants who gave birth within a year of their alleged crime to be screened for postpartum depression and psychosis.

'Life-saving mental health treatment'

“The bill’s intent is to guarantee that individuals who experience serious perinatal psychiatric complications, which includes but is not limited to postpartum psychosis, it ensures that these folks receive life-saving mental health treatment in cases where a psychotic episode results in involvement with the criminal justice system,” Healy explained.

The bill would also create a pathway for defendants who are found not guilty by reason of mental illness to receive a treatment plan and related psychiatric services.

O’Day told MassLive in a recent interview that he intended to file the bill in the next few weeks. 

Another related bill, co-sponsored by Rep. Danielle Gregoire, D-Marlborough, would require MassHealth to cover postpartum depression screenings for up to one year after childbirth during pediatrician visits.  

“The issue that this bill in particular is trying to address is the under diagnosis of postpartum depression because, a lot of times, women don’t have screenings until six to 12 weeks after they give birth," Gregoire said in an interview. "And at some point, it’s already too late to diagnose not only postpartum depression, but other issues as well."

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The bill has been filed four times since 2017 but has yet to garner enough support to pass the Legislature.

“Sometimes, there’s just not enough consensus around an issue or there are other issues that are more timely,” Gregoire said. “Somewhere in the neighborhood of 10,000 bills get filed every session and sometimes good change takes significant time.”

Will different State House makeup lead to change?

The Marlborough representative also said legislators may have been remiss not to pass this measure in the past but she thinks changes in the makeup of the State House will lead to change.

“Now that we have more women in the Legislature, more women of color in the Legislature, I think moving forward, you’re going to see some movement on a lot of these things,” Gregoire said.

Another bill discussed during the Ellen Story Commission meeting would increase access to mental health care for patients post-pregnancy. The proposal does not set a specific time limit set on “post-pregnancy.”

“Basically, what the bill will do is require full coverage insurance, whether public or private payer, for mental health care," said its sponsor, Sen. Becca Rausch, D-Needham. "And we intentionally use the words ‘post-pregnancy’ rather than postpartum to incorporate post-miscarriage mental health care and any other circumstance where pregnancy ends and there is no living baby."

Many commissioners expressed that in the wake of the recent tragedy in Duxbury, they would like to see this series of perinatal care legislation passed this session.  

“We are at a moment where people want to see some real change and it’s well overdue,” said Healy.