Bridging the gap in maternal mental health care
UF College of Medicine launches multidisciplinary perinatal psychiatry rotation for residents
Oct. 8, 2024 — Every mother’s journey is unique. But for some, welcoming a new life into the world can also bring debilitating mental health challenges. According to the American Psychiatric Association, an estimated 500,000 women in the U.S. suffer from a mental health or substance use disorder during or after pregnancy each year, but less than 25% receive the care they need.
At the University of Florida College of Medicine, a new multidisciplinary perinatal psychiatry rotation is stepping up to train physicians in bridging this gap. Thanks to a collaboration between the Department of Obstetrics and Gynecology and the Department of Psychiatry, fourth-year psychiatry residents will join first-year OB-GYN residents to spend a month training in UF’s perinatal mood disorders clinic with clinician and educator Kay Roussos-Ross, M.D. ’02, MPAS ’98, who is triple board-certified in obstetrics and gynecology, psychiatry, and addiction medicine.
“Mothers are a huge portion of our population,” said Christina Bulleit, D.O., one of the chief psychiatry residents for the 2024-25 year and the first fourth-year resident to rotate with Roussos-Ross. “Being able to feel confident and comfortable working with these women is something I want to learn more about. I have a new excitement and joy about working with these mothers, being there for them, and helping in their challenging times.”
The need for accessible perinatal psychiatric care is underscored by the scarcity of mental health physicians in both the U.S. and Florida. As Roussos-Ross points out, many patients face agonizing waits — sometimes months or even a year — before being seen by a psychiatrist. As a UF alumna, Roussos-Ross started the perinatal mood disorders clinic in 2015 to serve as a stopgap, providing immediate access to maternal mental health care for patients and helping to train the next generation of competent, compassionate clinicians. Since the clinic opened, every UF OB-GYN resident has rotated through it, gaining the experience and knowledge needed to care for women with mood disorders in their future practices, Roussos-Ross said. Patients can visit the clinic every Thursday afternoon for an initial consultation to discuss medication management, therapy, and treatment options.
Roussos-Ross added that the clinic’s integration with the OB-GYN department helps reduce transportation barriers and the stigma associated with seeking psychiatric treatment; Mothers can come in for an OB-GYN appointment and mental health care in one trip.
“There’s still some stigma with seeing a psychiatrist, unfortunately,” Roussos-Ross said. “For some patients, that may prevent them from going. Giving them the ability to have psychiatric care within the OB-GYN clinic removes the obstacle of stigma, and then hopefully that stigma will lessen with the more patients we treat.”
While a handful of women’s mental health and perinatal psychiatry fellowships exist in the U.S. for subspecialization, it is less clear how many programs offer residents a similar hands-on experience. Manonmani Murugappan, D.O., the outpatient chief psychiatry resident at UF, credits associate professor and psychiatry residency program director Ludmila De Faria, M.D., DLFAPA, for making this interdisciplinary training opportunity possible.
“When we were interns a couple of years ago, our whole class, and the classes before and after us, expressed interest to Dr. De Faria in wanting to learn more about perinatal psychiatry because we have patients in that reproductive age range, and we wanted to be more comfortable with psychiatric medications and counseling those patients,” Murugappan said. “Dr. De Faria is a huge advocate for women’s mental health, and she said, ‘Let’s see what we can do.’ Now we are seniors, and we’re excited that the rotation came to fruition.”
Developing the rotation was a group effort, De Faria said, and one that will help reduce the shortage of U.S. psychiatrists trained to care for women facing mental health issues related to reproductive transitions.
“There is an urgent need for residency education to include a reproductive psychiatry curriculum and a strong desire among trainees for more resources and opportunities,” she said. “I am very excited and grateful to all who contributed to the development of this opportunity, including Drs. Bulleit, Murugappan, and Roussos-Ross. We will continue to offer it as an elective rotation to all senior residents, and I have plans to expand it to include consultation-liaison, inpatient addiction, and outpatient training.”
Bulleit and Murugappan added that learning from Roussos-Ross and hearing her perspective as an obstetrician-gynecologist is a special experience that showcases how physicians across specialties can make decisions together rather than in isolation, ultimately providing the best care for patients.
“It’s such a unique opportunity to be able to work with another specialty,” Bulleit said. “We’re really welcoming the collaboration of care.”