Sarah Swenson

Immigration policies are creating impossible choices for NICU families.

Parents are afraid to visit their infants, deterred by anti-immigrant rhetoric and fear of U.S. ICE actions at hospitals.

Ask your legislator to support the Protecting Sensitive Locations Act.

With @neodrswenson.bsky.social

Join the NJC Policy and Advocacy Committee on August 27th at 3PM EST for a talk on Family-Centered Care in the NICU. #healthequity #familycenteredcare #neonatalcare #nicu

Yay! Can’t wait!

Just 2 days to register at early bird rates! Don’t miss out on @neoconsortium.bsky.social symposium + pre conference workshops! @berlinbabydoc.bsky.social @lamiasoghier.bsky.social @joannelagattamd.bsky.social @efischnicupsych.bsky.social @nicupodcast.bsky.social @aapneonatal.bsky.social

We’ll also share strategies for promoting wellbeing amongst NICU team members & advocating within your institution for more embedded psychosocial support for NICU families. Hope to see you there! @lamiasoghier.bsky.social @joannelagattamd.bsky.social @nicupodcast.bsky.social @unmccom.bsky.social

Advertisement for pre-CHNC symposium workshop on strengthening mental health support for NICU families and teams

<2 weeks left to register with early 🐦‍⬛ rates! Join us @neoconsortium.bsky.social symposium this fall. We’ll troubleshoot barriers to supporting NICU parent mental health, discuss screening for symptoms beyond depression & inclusive of dads & partners, practice trauma informed conversations & more!

Association Between Out-of-Pocket Insurance Costs and Psychotherapy Utilization Among Commercially Insured Birthing Individuals Perinatal mood and anxiety disorders (PMADs) are common, burdensome, and costly pregnancy complications, yet few receive treatment. Out-of-pocket costs (OOPCs) may represent a significant barrier to P...

If we want more people to get help for perinatal depression, removing co-payments for therapy might help.

Study by @stephanievhall.bsky.social & co found enrollees in employer-sponsored plans who had perinatal mood/anxiety disorders had more therapy visits if their out-of-pocket costs were lower.

100%! Effective screening programs do more than screen. It’s not about checking a box or patting ourselves on the back, it’s about moving the dial to improve support for families who have experienced the stress and trauma of a NICU stay, both during hospitalization and after discharge!

Save the date for 11/9/25 workshops on strengthening mental health support for NICU families and teams at the CHNC Symposium in Denver, Co

Thanks to @springernature.com for the opportunity to share this work.

If you want to learn more about screening & supporting parent mental health, check out our upcoming pre-symposium @neoconsortium.bsky.social workshop

@neotecan.bsky.social @nicupodcast.bsky.social @neojusticecollab.bsky.social

There is still a lot of work to do to better understand the experiences of NICU parents & how best to support them, including their mental health. I hope to partner with more NICU families & parent organizations in this work!

Thank you @unmccom.bsky.social & UMN colleagues for supporting this work

Parent input is essential to determine optimal screening practices. We tracked percent of screens declined in addition to parent surveys, which was helpful, and more work is needed to understand what is an expected/acceptable rate, and what indicates a need to further improve local programs.

Our screening algorithm was not followed perfectly, which we think was due to using 2 screens (depression & anxiety) & different thresholds for referral for mothers & partners. Electronic screening may improve this.

More work is needed to understand optimal thresholds for referral for NICU parents

Screening that is inclusive of fathers & partners is essential. Efforts should be made to ensure screening & educational materials as well as available resources include all parents.

NB: The National Maternal Mental Health Hotline can be used by any parent who needs help in real time 1-833-852-6262

Without universal screening using validated tools, we risk missing opportunities to support families in the NICU, especially later in the NICU stay when they may have fewer interactions with the social work team.

More work is needed to understand how best to support parents during long NICU stays.

In summary, we found that our standardized perinatal mental health screening program improved detection of mental health concerns beyond the first few weeks of admission. This is important because many NICUs rely on informal assessments to determine what support parents might find helpful.

All neonatologists & social workers identified standardized mental health screening in the NICU as valuable. However, the workload was not perceived as manageable for the social work team.

Quality screening takes time to perform, & systems need to account for this to ensure screening is effective

Our QI team included parents of children who were previously hospitalized in the NICU. To further include parent perspectives, we asked parents about screening using short surveys at each interval. The majority of parents identified screening as valuable & did not find screens difficult to complete

For partners, a higher percent had scores concerning for depression and/or anxiety at 1 and 6 months compared to 2-4 months, though few were eligible for 6 month screens.

Compared to the pre-screening period, screening increased the percent of mental health concerns identified in partners fivefold

We screened 80% of mothers and 72% of partners using EPDS and EPDS-3A.

60 (38%) parents had scores concerning for depression and/or anxiety. A higher percent of mothers had scores concerning for depression and/or anxiety at 4-6 months

Prior to screening, our social work team identified mental health concerns in 52 parents, primarily in mothers (94%) and the majority identified within 1 week of birth (73%). 12 concerns were detected at or after 1 month.

The only parents we did not try to screen were those that were already receiving mental health support or those for whom we did not have resources to support because they lived outside the US or were incarcerated. Careful consideration should be given to exclusion criteria to not worsen disparities

Eligibility criteria for screening is easier in outpatient settings, although most clinics are only screening mothers. But there are many barriers to being at bedside in the NICU. We wanted to support as many parents as we could

Although more work needs to be done to determine optimal screening intervals for parents in the NICU, a higher percentage of parents had screening scores concerning for depression and/or anxiety at 4 months and 6 months. Programs that screen only once may miss opportunities to support these parents.

We screened parents of babies who were 1, 2, 4 and 6 months old. We did this not only because these are the screening intervals used at well newborn visits but also because we know symptoms can change over time. The trade off is that multiple screening intervals creates more work for screening teams

3) how do parents view screening @fcctaskforce.bsky.social @hopeforhie.org @necsociety.bsky.social and 4) is the workload associated with screening manageable for our social work team?

To fill the gap, we developed a mental health screening program for parents of babies in the NICU and asked 1) can we screen the majority of parents in our NICU, including fathers and partners 2) how does screening impact our ability to identify parents who may find mental healthcare helpful

Although our NICU had phenomenal social workers who we knew provided vital support to parents, we wondered if there were parents whose mental health symptoms weren’t recognized through clinical interactions. Would screening help us better understand and support parent mental health in the NICU?

Even before depression screening became an AAP standard of care for NICUs, we recognized a gap in the care we provide families in the NICU when compared to pediatric well child checks, where universal depression screening using standardized tools is part of routine newborn care.

Perinatal depression screening has been an @aapneonatal.bsky.social standard of care since 2023.

What do we need to know to do this work well? @neoconsortium.bsky.social @ebneo.bsky.social

Here are some of my thoughts after working with teams to build screening programs from the ground up 🧵

📣Publication alert📣

Highly anticipated "Consensus Recommendations to Improve Neonatology Staffing" are out now!

These recommendations prioritize patient safety & physician well-being & will greatly benefit our patients & workforce.

Please read and share widely!

doi.org/10.1542/peds...