A recent study highlights significant gaps in mental health support for caregivers experiencing perinatal mood and anxiety disorders (PMADs) across the United States. The research, led by Erin O’Connor, professor of education and director of NYU Steinhardt’s Early Childhood Education Program, surveyed more than 900 caregivers and conducted 17 in-depth interviews to assess experiences with healthcare systems, workplace policies, and support networks.
“These findings confirm what families and advocates have been saying for years: our fragmented system is failing parents at one of the most vulnerable times in their lives. Too often, caregivers experiencing PMADs suffer in silence. Our data show that many are never screened by their providers, leaving them to navigate serious mental health challenges on their own,” says O’Connor.
The report, titled Missed Screenings, Missed Support, was produced through Nested—a nonprofit co-founded by O’Connor and Robin Neuhaus—aiming to advance family wellbeing through research-driven solutions.
Among the key findings: 40% of caregivers who experienced a PMAD were never screened during follow-up appointments; 98% of non-birthing caregivers such as fathers or same-sex partners were not screened despite reporting symptoms; parents with infants in intensive care had a significantly higher likelihood of developing PMADs; families with over 12 weeks of paid leave were much less likely to leave their jobs; and those living in rural or underserved areas struggled to access specialists.
Lisa, whose case was featured among several interviewees supplementing survey data, described her experience juggling two babies in different parts of the NICU while her husband received only two weeks of paternity leave. “My husband only got two weeks of paternity leave, so I was mostly alone.” She also noted difficulties seeking therapy: “The command will say, oh, we support you in all the military spouse appreciation months. It’s just talk…If you actually appreciated us, you’d staff hospitals and provide child care that works.”
Caregivers reported reluctance to disclose mental health concerns due to fears about judgment or separation from their children.
The study recommends improving screening systems for PMADs to build trust between patients and providers; implementing federally provided paid leave for families; expanding Medicaid coverage for comprehensive perinatal mental health services; increasing training for healthcare providers; offering telehealth options for remote areas; providing financial credits or assistance for childcare costs; and supporting both online and in-person caregiver groups.
“We can no longer treat perinatal mental health as optional or secondary. Families need consistent screenings, accessible mental health and child care, and policies like paid leave that make it possible to recover and thrive,” O’Connor says. “These are not luxuries. They are essential investments in the health of parents, children, and communities.”
