Equal Footing will address the racial and socioeconomic inequities in mental health care. We will create opportunities to empower, educate and build community. We will work collaboratively with leaders and members in the communities from which our clients come. We will center the voices of the marginalized and we will provide services and access to individuals and families that are pregnant, parenting and/or have experienced loss.
To reduce disparities in mental health care through accessible, effective and holistic programming that serves individuals that are pregnant, parenting and/or experienced loss.
Why Equal Footing?
Equal Footing was started in an effort to address the disparities in maternal health care experienced by women of color. Birth outcomes for women of color are significantly worse then their white counterparts in many areas, including, maternal mortality and infant mortality. In addition to birth outcomes, women of color are suffering from perinatal mood disorders at far greater rates and it is going unnoticed. Something must be done.
Check out what the data tells us!
In the case of Maternal Mortality Black women in the United States are up to three times more likely to die in pregnancy and childbirth compared to white women. Maternal mortality rates persist regardless of class or education status. Deaths among mothers extend beyond the period of pregnancy or birth. Nine months of prenatal care cannot counter underlying social determinants of health inequities in housing, political participation, education, food, environmental conditions and economic security—all of which have racism as their root cause.
Perinatal mood disorders (such as Postpartum Depression) have received more and more attention in the media, in health care and among new moms. However, the narrative is often centered from the experience of white women. This is misleading for many reasons, most notably because, studies have shown that women of color experience postpartum depression at a rate close to 38% compared with approximately 13-19% for all postpartum women (“Postpartum Depression and Race: What we all should know.” 2016). Racism is at the core of this significant difference. Black and Hispanic women who experience maternal depression have higher rates of adversities compared with their white counterparts. In a nationally representative study of the rates and risks of maternal depression in the United States, these adversities include poverty, employment issues, issues related to personal relationships, and marital problems.
Risk Factors for developing a Perinatal Mood Disorder:
- A traumatic pregnancy or birth: really sick during pregnancy, bed rest, complications, emergency c-section, NICU
- An experience with emotionally painful or stressful experiences around pregnancy, childbirth and/or early parenting: traumatic birth, breastfeeding issues, colicky baby
- A history of domestic violence, sexual or other abuse:
- A traumatic childhood: Abuse, neglect, attachment disorders
- Stress: Poverty, racism, sexism, homelessness, loss, or big changes.
- Lack of social support: Living far away from family, baby’s other parent is not around or helpful, no friends, military spouse.
“Stress” includes racism, misogyny, poverty and trauma. Facing racism and gender discrimination in the workplace, in the health care system, and in broader society negatively affects the mental and physical health of women of color while also inhibiting their financial independence. Furthermore, women of color tend to work in jobs that lack structural supports, such as paid sick days, paid family leave, and flexible scheduling—all of which are crucial for maintaining one’s mental and physical health and well-being. Without access to these supports, women of color disproportionately lack the time and flexibility required to regularly attend doctor’s appointments, which can be critical for addressing mood disorders. Women in this situation have to choose between neglecting their health because they lack access to these supports—potentially exacerbating health concerns—or losing pay or their jobs as a result of taking time off. Racism—including both overt and covert forms as experienced through structures or institutions—can also affect the mental health of women of color and have a negative impact on pregnant and postpartum women. These conditions can make it extremely difficult for women with mood disorders to parent. https://www.colorlines.com/articles/report-stress-racism-linked-maternal-and-infant-mortality-black-women
What the CDC found for the population-specific data was awful. From 2005 to 2012, the infant mortality rate for black infants decreased from 14.3 to 11.6 per 1,000 births, then plateaued before increasing from 11.4 to 11.7 per 1,000 births from 2014 to 2015. Comparatively, among white infants, the mortality rate decreased from 5.7 to 4.8 per 1,000 births from 2005 to 2015.
“The sustained progress in reducing infant mortality among black infants since 2005 has stalled in the past few years,” the researchers write. “This has led to increases in the absolute inequality in infant mortality between black and white infants during the past [three] years.”
The U.S. has some of the most sophisticated medical care, yet the country still lags far behind in the area of maternal and infant health care. According to 2015 data from the World Health Organization, each year approximately 60,000 women in the U.S. experience near-fatal complications during pregnancy or birth. Statistically, this puts the country in the same category of developing nations such as Afghanistan, Belize and South Sudan. In last year’s March of Dimes Premature Birth Report Card, the U.S. earned a “C” grade due to widening differences in prematurity rates across different races and ethnicities.
Access to Mental health care is a huge issue for low income individuals and women of color. The National Healthcare Disparities Report 2012 reported that “health care quality and access are suboptimal, especially for minority and low-income groups [and while] overall quality is improving, access is getting worse, and disparities are not changing.” Similarly, disparities in mental health care across race and ethnicity, geographic regions, and socioeconomic domains continue. Due in part to a lack of awareness/lack of screening of these disorders, African American women are also less likely to recognize and report symptoms for mood disorders, which translates into lower rates of mental health care utilization. African American women are half as likely to receive mental health treatment and counseling as white women. They are one of the most under treated groups for depression in the United States.
Did you know?
Pregnant women of color are under served by the mental health profession and relevant support services. When perinatal mood disorders are left undiagnosed or untreated, the results can be deadly. Suicide is a leading cause of maternal death for women with postpartum depression. Women of color are typically unaware that the mental health symptoms they experience are the result of pregnancy or childbirth, which also means that the symptoms often remain unaddressed both by the woman and her medical provider.
So, what do we do?
The Center for American Progress in response to the overwhelming data on health care disparities in maternal health care and maternal mental health has offered these recommendations:
- Support comprehensive health care coverage under the Affordable Care Act (ACA), including mental health services and maternity care.
- Improve access to culturally competent and well-trained mental health care providers.
- Fully fund the MOTHERS Act. https://www.govtrack.us/congress/bills/111/hr20/text
- Support the integration of mental health screenings into other health care settings.
- Fund large-scale, culturally appropriate public education campaigns.
- Conduct additional research on perinatal mood disorders.
- Develop policies and education campaigns in a way that takes into account the lived experiences of pregnant and postpartum women of color.
- Educate health care providers, patients, and communities about the importance of mental health care access.
- Support culture shift efforts.
- Amplify and support women of color-led organizations.
- Support policies that improve work-family balance for women in the workplace.
These actions are critical to helping ensure that pregnant and postpartum women of color can stop suffering in silence and can gain access to the necessary supports and services in times when they are experiencing perinatal mood disorders.
Equal Footing will collaborate with elders and members of communities of color to identify the needs of the women, we will support women of color led organizations, we will offer accessible services, we will work to advance public policy, we will recruit therapists of color, and we will provide education on pregnancy, birth, parenting, and loss from a culturally competent lens.
Delta Larkey, LMFT, CPLC
Licensed Marriage & Family Therapist
MN Board Approved Supervisor
My journey as a maternal mental health therapist began after the birth of my first daughter. My birth and postpartum experience revealed a lack of support and candor surrounding perinatal mood disorders, when birth doesn’t go the way you expected and the challenges of becoming a parent. It was this experience that spurred my desire to work with individuals and families along the reproductive journey. Alyssa Wright and I co-founded The Family Development Center in Fall 2013.
Alyssa and I recognized quickly that there were major disparities between individuals of color and low income individuals in accessing mental health care. We learned that Perinatal Mood Disorders impact individuals of color and disproportionate rates and yet people were not receiving services. It was this realization that led us to start Equal Footing.
I have spent a large portion of my career working with children, adolescents and families struggling with poverty, addiction and trauma. That work is never far from my heart and has shaped how I work with people. I believe it is my duty as a therapist to have an intersectional framework, which means always acknowledging the interconnectedness of social categorizations and their impact on disadvantage and discrimination.
Alyssa Wright, M.A., LMFT
Licensed Marriage & Family Therapist
MN Board Approved Supervisor
My partner, Delta and I started The Family Development Center three years ago with the hope of helping individuals and families manage roadblocks that arise along their journey towards the life and family that they desire. These roadblocks may include depression and anxiety during and after pregnancy, infertility, loss, miscarriage and parenting challenges. And, they can feel devastating. We are here to provide support and information in order to get through these tough times.
I believe in focusing on the best in people and recognizing the strength and resilience that have brought them this far in life. I am direct, honest, kind and use humor to help work through difficulties.
Laura Barbeau, M.A., LMFT
Clinical Supervisor for In-Home ARMHS Program
Licensed Marriage & Family Therapist
MN Board Approved Supervisor
As a maternal mental health specialist, I have become a bit of an activist for social justice. I see clearly how women in this country are denied the basics of what they need physically, emotionally, financially at the most critical time in their children’s and families lives. In fact, I believe it is inhumane that in Contemporary American society, we have an unrealistic expectation of rapid return to pre-pregnancy functioning. These unrealistic expectations land much more harshly for women of color in marginalized and underserved populations. It is my professional and personal honor to be doing work that provides access to supportive mental health services for mothers and their families who are experiencing oppression and neglect in our flawed medical system.
My experience in mental health includes work in school settings, providing in-home CTSS therapy with children and families, outpatient mental health clinics and in private practice. I have specialized in postpartum mood and anxiety disorders, emotionally focused couples therapy, attachment theory, grief and loss, depression and anxiety, bi-polar disorder, transition to parenthood and new family development. I especially love working with creatives, social justice activists and helping clients strengthening personal boundaries to have more rewarding relationships. When I work with clients I enjoy working collaboratively with curiosity and humor to develop healthy strategies to deal with life’s challenges.
I also provide Supervision for pre-licensed marriage and family therapists as a MN Board Approved Supervisor. In addition to focus on case review, I encourage supervisees to consider self of the therapist issues and prioritizing their own self-care. Supervisees can expect to grow as a therapist with increased knowledge, confidence in therapeutic skills and honing your identity as a therapist.
Mental Health Practitioner
My journey to becoming a marriage and family therapist started after receiving my bachelor’s degree in psychology. I wanted to further my education in order to implement change in human behavior. I pursued my master’s degree from St. Mary’s University of Minnesota. I have worked with both adults and children with a wide range of disorders and emotional disturbances. My experience working with adults piqued my interest in caring for younger children. Many adults’ issues arise from childhood and never learning to appropriately handle stress. I desire to help those little ones adjust and grow to be happy, healthy adults.
I typically take a non-directive approach to therapy pulling from Narrative and Internal Family Systems therapies. People tend to tell their stories that are focused and saturated with problems. I enjoy looking for those unique moments where a person has made a different choice which led to growth and shows the capability to change. Sometimes, there is a struggle internally and there are parts of you conflicting with another. I can help you navigate those different parts and understand their meaning. By providing a warm presence and safe space we can explore the challenges in your life and make sense of them together
Mental Health Rehab Worker
I am very happy to work with my community as a Mental Health Rehab Worker. I have provided services to individuals struggling worked with mental health concerns for over 15 years. I have both personal and professional experience in the difficulties that mental health disorders can bring. My son has had challenges navigating his own Mental Health.
I know my calling is to bring awareness, understanding, and much needed resources to our community. My life experiences coupled with my education (A.A.S. in Human Services) will be invaluable to the work of Equal Footing. I am extremely happy to be working with Equal Footing to get our community on the pathway to healing, understanding, and growth.