KU professor leads collaboration across disciplines to teach perinatal mental health care

Mental health conditions are the most common complication of pregnancy and childbirth, affecting one in five pregnant and postpartum women every year, according to the Association of American Medical Colleges. Yet three-quarters go untreated and undiagnosed.

Part of the reason for this shortage in care is that fewer than 500 psychiatrists in the United States are trained in providing reproductive mental health care to the 800,000 women a year who experience maternal mental health complications, according to the Maternal Mental Health Leadership Alliance.

Erin Bider, M.D., clinical assistant professor in the Department of Psychiatry and Behavioral Sciences at the University of Kansas School of Medicine, is looking to change that. Bider’s expertise in perinatal psychiatry — honed during her internship and residency at the University of Arkansas for Medical Sciences — makes her uniquely qualified to address the overall lack of training in maternal mental health care.

Bider joined KU Medical Center as a clinical assistant professor in 2021, founding the Maternal Mental Health Clinic within The University of Kansas Health System the same year. Over the past four years, she has worked alongside colleagues, students and students who have since become colleagues to bolster maternal mental health care education in Kansas.

“There was no reproductive psychiatry curriculum for residents [at KU Medical Center] before I started," Bider said. “What we've designed since is a curriculum for psychiatry residents that teaches them about taking care of women across the reproductive lifespan.”

A team approach

Pregnancy, Bider noted, is a multifaceted experience.

And so too is the health care provided before, during and after this time. Parents-to-be might be receiving care from both their family medicine doctor and OB-GYN, subspecialities traditionally focused on a patient’s physical well-being. Incorporating mental health care into a patient’s obstetrical care can, in Bider’s words, “break down the stigma” of asking for this help.

“When the person who’s managing your pregnancy is also asking you about your emotions, you feel like that’s what wellness during pregnancy looks like,” she said. “That goes a really long way.”

To normalize this aspect of care across subspecialties, Bider connected with Tara Chettiar, M.D., a clinical assistant professor in the Department of Obstetrics and Gynecology, to develop a series of trainings and lectures aimed at medical students as well as psychiatry and OB-GYN residents. These trainings, which include screenings of mental health conditions and potential substance abuse disorders during obstetrical visits, are designed to show “why this area of care belongs to everybody rather than nobody,” Bider said.

Ensuring comfortability in trainees to provide this multidisciplinary care is key, which Chettiar feels she and Bider achieve through their own easy rapport.

“It's always conversational,” Chettiar said of their teaching style. “And because we’re actually having a conversation and interacting with each other, I think learners respond to that because it feels much more engaging.”

By working together on these trainings, Bider and Chettiar show their trainees that collaborating with physicians across disciplines to provide perinatal mental health care is ultimately a strength.

“Part of our collaboration is an acknowledgment,” Chettiar said. “I think it’s important to know your limitations, and while I feel passionately about this work, this is her home. She can be a great safety net for me and vice versa.”

Creating a bigger picture

For Reshma Khanna, D.O., a fourth-year psychiatry resident, practicing this multidisciplinary care reminds her of a lesson she learned in medical school comparing EKG images to “pictures of a car from different angles.”

“You can only get a good sense of what’s going on if you have all those angles and perspectives,” Khanna said. “I think that translates so much to my experience at KU — seeing how psychiatry, OB-GYN, family medicine and others work together to create that picture and know exactly what needs to be done to help a patient.”

Khanna’s early interest in perinatal psychiatry has allowed her to learn from and work alongside Bider throughout her residency, including several electives on diagnosing and managing mental health care throughout one’s pregnancy and postpartum. She’s also been able to observe Bider as Bider collaborates with primary care and OB-GYN doctors to optimize this care on the basis of a patient’s specific needs.

The impact of receiving this education from Bider will stay with Khanna as she joins the University of Missouri as a perinatal psychiatrist after completing her residency.

“The opportunity to work with someone that specialized and being able to extend that legacy into another place is a role I’m really excited to take on,” Khanna said.

Bider’s efforts to position KU Medical Center as an institution of excellence in maternal mental health care education are paying off, attracting trainees to Kansas for an educational experience they may have previously received at coastal institutions.

“When I was interviewing for the residency, we would have question-and-answer sessions, and everyone was asking about perinatal and working with Dr. Bider,” Amanda Emerson, M.D., said. A first-year psychiatry resident, Emerson first worked with Bider during her psychiatry rotations as a medical student. “Her being here is drawing people in.”

Bider hopes that the options for maternal mental health care education at KU Medical Center continue to grow.

Given the upward momentum of interest in what’s been seen as a little-known subspeciality in incoming trainees, plus Bider’s success in developing multidisciplinary partnerships, the growth of this multifaceted education is a matter of when, not if.

“There’s such a need for this care and so it’s wonderful to see people get excited about it,” Bider said. “It’s rewarding to see people I’ve built these relationships with, whom I’ve been teaching and mentoring, find something that speaks to them and that they can do for the rest of their lives.”