Children and new moms stand to gain improved access to mental health services under two bills recently signed into law by Gov. Jerry Brown.
The Maternal Mental Health bill requires doctors working with pregnant women and new moms to screen these patients for postpartum depression and other mental health conditions. Under the bill, signed by Gov. Brown on Sep. 30, health insurers must also develop treatment programs for maternal mental health issues and guidelines for obstetricians on what to do when a woman screens positive for a postpartum mood disorder.
Kelly O’Connor Kay, interim executive director for the Los Angeles-based non-profit Maternal Mental Health Now, said the bill will help ensure more women get treated for postpartum depression. The second part of the bill requiring guidelines for obstetricians is especially important, she said, because it’s designed to make California’s law more effective than bills in some other states that only require screening.
Currently, less than one in four women with maternal depression receive treatment for the disorder, usually because they’re never screened for it, O’Connor Kay said. The problem is particularly severe among low-income and immigrant women, as well as domestic violence survivors, who are at highest risk for pregnancy-related mental health problems, she said.
“Untreated postpartum depression can lead to chronic depression. It affects the attachment that’s supposed to form between a mom and a baby during the first year of life,” she said. “If that’s not addressed then that results in negative outcomes for the child growing up: The child’s more likely to develop behavioral and cognitive developmental delays.”
Another bill newly signed into law addresses children’s mental as well as physical health needs directly. SB 1287 clarifies the definition of medical necessity for children enrolled in Medi-Cal, the state’s health insurance program for low-income residents. The clarification aligns California’s definition with that of the federal government’s, ensuring children get broader coverage than adults for a variety of physical, mental and dental health services.
Until now, state language around medical necessity for children has left many Medi-Cal providers confused, said Linda Nguy, a policy advocate at the Western Center on Law and Poverty, which co-sponsored the bill. That’s resulted in children being denied necessary services because providers mistakenly use eligibility rules meant for adults.
Legal aid centers affiliated with the Western Center have reported numerous cases of children incorrectly denied services under Medi-Cal, and documentation of appeals cases backs that up, Nguy said. Dental care, particularly braces, are the most commonly denied services, she said. There are also reports of children not receiving needed care from county mental health plans and Medi-Cal managed care plans, she noted.
“Children are not just little adults. They have distinct health needs that are different from adults, so having a broader standard is important,” she said. “Early prevention services are crucial for children. Having access to services early on and in the development process is particularly important for children because it can have life-long consequences.”
Two other new bills also target children’s health. One will require restaurants to serve water or milk with kids’ meals instead of less healthy drinks such as soda, unless parents request otherwise. Another aims to reduce children’s exposure to toxic chemicals by banning the sale of upholstered furniture, mattresses and kids’ products containing high levels of certain flame retardants starting in 2020.