Subscribe
Share
Share
Embed
We are the Maternal Health Learning and Innovation Center, a network of maternal health equity experts and organizations working to make real change for women and birthing people in the U.S.
Our podcast is a series of episodes connecting around culture, lifting voices and stories, exploring innovations in maternal care and discussing ways we can center equity in the way we approach our health and wellness.
Learn more about us, explore our resource center and find support for all maternal health professionals at MaternalHealthLearning.org.
For more podcast information and content, visit MaternalHealthPodcast.org.
Kelli - 00:00:04:
Welcome to the Maternal Health Innovation Podcast, Season 4. I'm your host, Kelli Sheppard, Communications Director at the Maternal Health Learning Innovation Center. On this podcast, we listen to maternal health innovators about ways we can implement change to improve maternal health in the U.S.. Be sure you're subscribed. In today's episode, we're talking about maternal mental health with Amy Green. Amy is a leading clinical social worker and entrepreneur specializing in maternal mental health. With over a decade of experience, she is the founder and CEO of Nashville Collaborative Counseling Center, or NCCC, and Mamaya Health. NCCC, established in 2019, focuses on accessible evidence-based mental health care for perinatal mood disorders, trauma, and children's mental health. In 2023, Amy launched Mamaya Health, a virtual mental health service expanding maternal mental health care across multiple states. Amy holds an MSW from the University at Buffalo with certifications in integrated care management and maternal mental health. She has received numerous accolades, including being part of the EY Winning Women of North America 2023 cohort and being named to Nashville Business Journal's Most Admired CEO list in 2023. Congrats, by the way.
Amy - 00:01:44:
Thank you.
Kelli - 00:01:46:
I appreciate you joining me, Amy. Thank you so much.
Amy - 00:01:49:
I'm so glad to be here. Thank you, Kelli.
Kelli - 00:01:52:
So I would like to start off with asking you to tell us a little bit more about Mamaya Health.
Amy - 00:01:58:
Sure. So Mamaya Health originated out of, I had three losses before we had our first and I couldn't find a therapist to help me. I really struggled to. Just process the grief that I was feeling, process the anxiety I was feeling as I went into the next pregnancy. I really struggled and couldn't find a therapist that didn't want to just talk about a Kugler-Rothschild model, which is like, are you angry? Are you depressed? Right? Like, are you resolved in it? Which makes sense for a lot of grief. But in this season of life, when you are becoming a mother, you know, I think for me, at least. My kids are always a part of my life, whether they're my angel babies or whether they're my living children, right? And so how am I mom without being seen as a mom? Because I don't have a living child. And I needed somebody to be able to have that conversation with me. And I really struggled. So I started Mamaya Health to ensure that there are safe spaces for us as women to have these conversations and the multitudes of conversations that are worthy and deserving of holding space for throughout our reproductive journey. Whether that's, from the time that we get our periods and we're starting to be able to reproduce as a woman and trying to understand that. To the seasons where we are starting to explore and have sex and get to know partners and all those things and who we are in this world. The time that we decide to start a family and how we journey into that, we are taught so often, Kelli, how to prevent a pregnancy. We're not taught as women, then the journey forward from that, right? So once we get pregnant, or if we can get pregnant, or how we get pregnant, is oftentimes not the center of the conversation. It's how do we prevent it? And then the flip side is the other side, right? So like, if I didn't become a mom. What spaces exist for me to negotiate and talk through and hold that conversation and be held and seen in that. And then the journey forward of like, to menopause, right? Now I'm no longer able to reproduce. This has been the majority of my womanhood, the majority of my life experience. And now this is not available to me. And what does that do to me, to my existence, to my body, to my being? And so that's my health. That's what we exist here for, is for women to talk through the life cycle of being a woman and all that it is deserving of holding space for. The virtual model comes from a place of understanding that as women. We are oftentimes navigating our familial life, whatever that maintains, our friendship life, our work life. The multitudes of doctors that we see to try to ensure that we are healthy and cared for and tended to. And so virtual maternal mental health care means just that it's it's health care that's delivered virtually so that it can meet you wherever you're at, whenever you need the care. And is accessible and affordable. And so we make sure that we are in network with commercial insurances so that we are affordable, but then also accessible through a virtual telehealth platform.
Kelli - 00:05:04:
Awesome. So can you discuss a little further or a little more rather the technological development and implementation process for Mamaya Health? Like how has the platform evolved since its launch and what updates can users look forward to in the future?
Amy - 00:05:21:
Sure. So we have been embedded into a EHR, an electronic health record system that has a telehealth component to it. It utilizes Zoom as a platform. And all of that is very helpful. It's very accessible. It's very easy for the user. And we want to see that it becomes more integrated with the data and the measurements so that we know how we're tracking and trending in our care delivery. So we understand when it is effective, when there is improvement, when there is increasing symptoms, and that we can be responsive to that. So... As it exists today, we have separate systems. And what we're looking forward to is integrating those systems so that we are able to be more responsive and deliver content and evidence-based practices to our clients. On the spot once they complete a screening that is content that is going to be supportive to them. So an example is if all of a sudden I stopped sleeping and I'm having trouble sleeping, I'm sleeping, let's say less than four hours a night, which again, when you have a baby. But all of a sudden, it's not sleeping. And I can't fall asleep and I can't stay asleep, then what are healthy sleep habits? What are going to be a sleep meditation or something I can listen to to calm myself down, to distract my brain from what might be anxiety thoughts or worry thoughts or something like that? So it's going to deliver content to the client, but it's also going to deliver then content to the therapist and interventions to the therapist that's going to prompt them and support them in understanding where they need to track. In the next session and then deliver interventions that are going to immediately attend to the distress that the client's experiencing.
Kelli - 00:07:06:
That's awesome. I can really appreciate the all-encompassing care model that you're implementing there. I had a little bit of postpartum. I got pregnant really quickly in between kids, like 14 months. They're 14 months apart. And I had some maternal mental health concerns that didn't really get taken care of until I literally had to force my care. That's the only way I can say what I want to say there. but, having something I want to say what I want to say is that having something like Mamaya Hill would have been wonderful. I appreciate that you have this platform, that it's helping others. And if we could share what the general reception of Mamaya Health has been like, what feedback have you received from users and has it at all, has the feedback that you received from users at all influenced the evolution of the app itself?
Amy - 00:08:17:
Yeah. You know, I think... I wore the vote for mother hat today, not unintentionally. We did a recent kind of campaign with a Instagram influencer who means Aspen. She's amazing. She runs an account called happy, Happy Little Mother, and talks a lot about her journey and her story. I'm like looking her up as I'm doing this because I want to be able to speak to the numbers. But like the reception is just, I think that that's probably what's blown my mind the most. Um, and it's so humbling, the reception of it. Because, there's so many women out there that talk about, how meaningful it is for them to know that there's a space. And. It just, it blows my mind that this doesn't already, that they don't already have a space, right? And I think that that's what. I feel so passionate about. That's what drives me every day is like, and that's what drove me to try to find him in the first place. Right. I'm like, where the hell, where the hell do I exist in the world? Where are the women who have my story? I need to connect. And I feel so alone in this. And I surely can't be the only woman who's ever had a miscarriage. But in 2014, 2013, that wasn't something that was talked about. It wasn't, you know, when I say that in like a, like, aha, way 10 years ago, but like really 10 years ago, even. This wasn't something that had a lot of resources. It wasn't something that was talked about. When I got certified in maternal mental health, I was one of five people, the first five women trained in Tennessee, right? And that was 2018. So it's not far-fetched to me to think that we've made a ton of progress, but there's also so much more that we deserve as women to have care around. Aspen was able to create, you know, I mean, just so much awareness for us. And I'm so grateful for that. And, you know, like one video had 92,000 views. How many women did that then? Impact, touch. And I, and I reminded Aspen of this, like, it's not about, it's not about the, you know, fundraising. It's not about the dollars at the end of the day. It's like, Who asked for help? Who spoke up? Whether they came to Mamaya or they went somewhere else, who said, I am not okay? Because they saw that and they saw somebody else talking about it. And then they found the courage inside themselves to name it and to go forward. That's what means the most to me. Um, and so I think the reception that I've experienced around my health is just, I mean, it's, it's humbling. It's been, women are excited. We have investors that have been very excited about being a part of it, who said that this has been needed for a long time, that they're so thrilled that this exists. They believe in it. We have men, right? Male investors who've come alongside that are our allies and our deep supporters. And they've walked through infertility journeys and other journeys with their partners. And it's impacted them too, right? Because this doesn't just impact women. And so I'm just so grateful. I think like the general reception for me as a founder has been full of humility and gratitude because I... Both in awe of what exists and in awe of how it's coming together. The opportunities that I've had to sit in other spaces to speak about this and to talk about our mission and our vision and what we want to do, I'm grateful for because I feel like it's only stewarding this in other spaces that might not have been talked about previously. And who knows what difference that can make. So I'm grateful because the reception has allowed me to be able to enter spaces to advocate on all of our behalf as women. And speak to the need. And then, I mean, the feedback from users is just that it's access, right? Like it's access, it's affordable, it's easy. Our therapists are incredible. I'm so grateful for the women who have training as LCSWs or LPCMH SPs in this world who come alongside us and say yes and offer services and support and join our platform so that they can create access. Most of these clinicians have their own private practice. They're making, you know, again, money on the side, running their own businesses, but then join us because insurance is oftentimes really difficult to navigate on your own if you own a private practice. And so they join our platform so that we can help support that. And they see 10 to 15 clients a week. It's not a ton, but it's enough. And then together, because of that together, we can have a really big impact on statistics like, you know, postpartum being the leading cause of death and postpartum. And so like, how can we reduce suicide, reduce things like this, because we together are having an impact and an influence.
Kelli - 00:13:01:
Very, very insightful. I'm glad that you're receiving so much positive feedback about this platform. And I'm excited about the future that this platform has because, from the sounds of it, it's kind of in its like infancy, toddler stages, if we want to, you know, relate it to childhood development.
Amy - 00:13:25:
Kelli, is it ever? You tell me, girl.
Kelli - 00:13:29:
It has so much potential. I'm really rooting for it. And great positive feedback, but have there been any challenges? And what are some of the common issues or concerns that people feel like? That Mamaya Health can intercede in, if that makes sense. How is Mamaya Health totally interceding for others in maternal mental health?
Amy - 00:14:07:
You know, I think the challenges, the challenges are not unknown to most who work in the mental health field, right? So you have systemic issues that are, whether it's, you know, state by state licensing, which makes it challenging to get across state lines. If you have people, we live in Tennessee, I live in Nashville. And so, you know, if there's a woman in Kentucky across the border who needs help. I need a Kentucky therapist to help her. Right. And so like challenges like that, that, you know, during COVID seemed to be a little bit better. But COVID has ended the regulations and the uses of some of those have ended. And so it's becoming more challenging again. And so I think, you know, the expansion, the ability to go national, the ability to do that well and be an integrity to the ethics and the legal, the legalities between states and compliance between states is, you know, I mean, that's something that I, as every day as a founder work through. Yeah, I think the challenges in mental mental health care is that, you know, there are not great areas for women to go to that take insurance. Right. And so I would echo again, like that is where we can make the biggest impact. That's where we can be the most support. That's where we can be the biggest help. We take insurance. We specialize in this. We have therapists who want to support and serve this season of a woman's life. Um, and we want to make sure that there is a resolution to it at the end of the day so that women feel like, you know, again, whether it's like. They're thriving in who they are in their identity as a 20 year old. And they're figuring that out to I'm thriving in motherhood, or I'm navigating an adoption. And I feel like I can do that in a supported and held space, you know, or infertility, or even again, through menopause. I mean, those things impact our lives so much. And there's so many women who say that they feel confused, they feel, I've had a woman tell me that she feels dumb. And I'm like, you are not dumb. We're freaking director of an entire system, right? Like, you're not dumb. Hormones do a lot to us. And so how do we interpret these things? And how do we name these things? And how can we tell ourselves a different story that's more helpful and effective for us and supportive for us versus something that's stigmatizing, demeaning, dishonoring to what our experiences are as a woman in life. And so I think the common issues are that from the time that we start our periods to the time that we, you know, are now, are now in menopause. No longer able to reproduce, the biggest challenges to me feel like. There's a lack of support in both hormonal care and then also just like that psychosocial transition through from 12 to 55, 60. Our lives change so much. And our homerooms change so much. And so how do we balance both of those and get support for both of those and be met with understanding and not have it something that is stigmatized or judged or, you know, again. In our society, we can be punished for that. Like, you know, we can get demotions because we're confused or we feel slower or we get, you know, take time off of work and we don't have the same financial gains that or opportunities that others might have because of that. And so I think how can we be met in this with an understanding of this is just a beautiful ebb and flow of how we as women operate in this world. And it doesn't look this like consistent study. It's an ebb and flow and be met with that in our systems and be met with that in our opportunities.
Kelli - 00:17:48:
I got you. So, with suicide being like the leading cause of preventable death in the postpartum period. How do you think that collaborative care models can help in reducing tragic outcomes like that? Like a care model like yours, how can that help prevent?
Amy - 00:18:07:
Kelli, I've spent so much time the past two weeks in the research around collaborative care modeling and the numbers and the data, and I just like, I can't advocate more for this to be the model of care. When I first came into the field and started working in like a C-suite role 10, 15 years ago, collaborative care, integrated care management was something that was like new and trendy. They had, HRSA had released this primary care modeling, right? That like we can have these primary care homes and it's great. And it was this idea, this idealistic thing where, you know, if we go to our PCP, we can get this one-stop shop to treat the whole person. What we know to be true as women is that the PCP is a stop that we see maybe once a year. We see our OB so much more. We see our OB-GYN so much more. And again, from the time that we're sexually active to the time that we're going through menopause, we are receiving care from them and being checked in with. That is, again, a place as women that we then can be met in care. So this integrated care model is such a, I mean, I hate to call it groundbreaking, but it is groundbreaking in so many ways because it is such a opportunity for us as women to have. An OBGYN provider who's so brilliant and so well-rounded in their versatility for how they support women, both in, again, that pregnancy and reproductive season, but also the seasons beyond that on the front and the back end. But then also like when a mental health screening is applied. And something is flagged. The nurse, the doctor can tag that behavioral health care manager into the team. And because they're integrated right there, there's this warm hand up. Do you know, Kelli, that there is a 75% increase? In translation from the time that a referral is made from a behavioral healthcare manager to a therapist, a 75% client acquisition increase, which means that the client now sees and closes with a therapist, right? Which is a big deal. If there's a 75% increase in referrals and closing of those referrals, so they've completed an intake session, that means that there's a 75% increase in access and completion of care. And so that many more women are getting access to and attending treatment. And that is how we reduce suicide. That is how we catch people. Who are really hurting, really struggling, feeling alone, feeling isolated, feeling hopeless, feeling worthless, feeling like they want to escape their situations. And again, if you add psychosocial impacts into that, there's a zillion different psychosocial things that happen in our 20s and our 30s and our 40s and our 50s. Um, And so how do we make sure that women have access? And that we have a warm handoff from a trusted provider who we see every year, who's saying, hey, something's going on, I care about you. I want you to go and make this appointment. Exposes and seals a deal for most people who are needing that bridge to take, to reduce the stigma, to reduce the barriers to care, to reduce all that. If we give them a brochure, Kelli, like, Kelli, what did you do with brochures?
Kelli - 00:21:40:
They hit the trash very quickly.
Amy - 00:21:41:
There you go. Right?
Kelli - 00:21:44:
I couldn't tell you where any brochure is located ever that I've ever received.
Amy - 00:21:49:
Right? It's like marketing dollars down the drain. And that, I mean, again, like it's not for a lack of not wanting that information. It's an additional burden. It's additional mental load, an emotional burden that I have to carry. It's like another thing on my to-do list that I have to do, right? That I like literally cannot handle, especially if I'm feeling anxious or depressed or struggling to sleep, or I'm trying to figure out how to get pregnant, or I'm trying to figure out how to grieve the loss of a baby, right? Like it's another thing. I don't need another thing. I just need it to be easy. I need it to be accessible and I need to not be judged. And when my provider tells me, there's this really easy person who's already integrated into my practice who will walk you down the hallway and get an appointment scheduled. All of those barriers are taken off the table. That makes a world of a difference to reduce suicide.
Kelli - 00:22:40:
I totally agree with that. Do you think that there are any policy changes you can discuss in their potential impact on maternal mental health and how they could even affect Mamaya Health work?
Amy - 00:22:55:
There are so many really good ones on the table. I literally have still kind of flagged on my computer. There's the Maternal Mental Health Policy Center and they have live bills addressing maternal mental health and they have a whole list of just current kind of opportunities on the table, current bills that are on the floor in different states or nationally. I think the one that I posted about most recently that I'm like really stoked about is a bill that Senator Jeanne Shaheen and Tammy Baldwin introduced called the MAMA Act. And it improves mental health care access for pregnant women and new mothers by eliminating cost sharing for services during pregnancy. And so this bill, I believe it's in Massachusetts, maybe nationally, I don't know. I would be remiss to say that I understand anything about politics. But I think that what I get more excited about around the bill, again, I know the senators, if the senators are involved, okay, let me backtrack. If the senators are involved, it is a national bill. There we go. And what I'm excited about for that is that it reduces the financial barriers. And this bill alone, make the MAMA Act, make mental health care accessible through that first year postpartum. So there's no cost, there's no copay, there's no deductible, there's no co-insurance. And that as a barrier, again, another barrier reduced, just allows us to enter care that much easier.
Kelli - 00:24:25:
I'm going to backtrack just a smidge and speak or ask a question from a business perspective, because earlier you were talking about connecting. I think you said the state of Kentucky, for example, if there's a mama in Kentucky, you want to pair her with someone or therapist in Kentucky. So why do you think it's important to hire individuals from the communities, like the direct communities they can impact?
Amy - 00:24:57:
You know, I think it goes back to so much of our mission, our vision, right? Like when... When I first started, so much of what I was motivated by, too, was also just this like, you know, seeing. And I don't mean it as like a slap on the wrist to anybody who's in private practice. I think that we all have to make choices that directly impact our financials and our family's lives and our ability to live and thrive in the ways that we want to. I was just very frustrated that that was the only solution that was on the table. And when you see research again in maternal health, again, this is going back in 2016, so earlier, but when you see research being only on white middle-class women and you see it only affordable to white middle-class women that look like me, right? It's completely underrepresented. For the multitudes of women that have these experiences, that need access to care, and that are deserving. And so I think the statement for me, I'm a social worker. I mean, that is embedded in my soul from the time I was a child. You know, the statement for me is how can I make this as equitable and as accessible as possible? And access doesn't just mean that it's affordable. It means that the women that's sitting across me, the woman that's sitting across me or the person individual sitting across me that's treating me looks like me. And it's from the communities in which I live in. Right. There's something that makes that, again, another equity-building bridge in our access. If that's another barrier to my care and I don't feel like I'm going to be seen or heard in that, that's going to make a difference in my decision making around entering therapy. And so at Mamaya, we do a really, I mean, I think that we do a really incredible job at fostering. A diverse pool of applicants and hires in making sure that it's representative of our communities and making sure that there are a multitude of backgrounds, a multitude of ages, a multitude of types of women and individuals who serve our communities and serve as therapists to support the women that we serve so that when a woman comes in and she says, you know what, this isn't a good fit, that we might have somebody else who might be a better fit that might feel safer because, again, that barrier is broken down.
Kelli - 00:27:13:
That's awesome, Amy. I certainly appreciate all the work that you're putting into Mamaya Health. Living the dream is what comes to mind because it sounds like you are. You said you just being a social worker and here you are impacting communities, impacting the lives of mamas. Hey, thank you. I appreciate your time.
Amy - 00:27:43:
I'm so grateful. If you would have asked me, hell, even in my teen years, you know, my sister and I were talking earlier today and we were talking about just the fact that like as an individual in my life, I've struggled with suicidal. I've struggled with mental health issues. I've struggled with things myself. Right. I mean, as we all have. And if you had asked me when I was 14, 15, 16, if I would have ever ended up. In front of people, in a podcast, having won awards, being a leader. Any of this stuff, I would have laughed at you. And we're like, that's, that's a joke, you know, but like, truly, like there was the bridge to growth for me was so real, but it's not without a lot of mentors and a lot of people believing in me. And I'm so grateful for that, Kelli, because there's so many people who have come into my life and who have poured into me and who have seen something in me that I didn't see in myself. There's this infant mental health concept. And I'm obsessed with it. It's called, it says, the saying is, you can't be what you can't see, right? And so as an infant mental health therapist, you go in and you try to bridge those gaps. You try to be... And bridge what might not be possible because maybe the mom's mom never played with them, right? Like maybe that was not something the mom, she cooked, she cleaned, she took care of them, she never played with them. She never interacted with them that way. And so how can we offer an opportunity for this person in a way that they can then grow their skillset as a mom and what it means to mom? It's just this beautiful gift. And there's so many mentors and people who've come into my life. Ada Haynes, Sherry Deutschmann, Michael Burcham, Linda Ragsdale, sweet thing. She's no longer with us. But these people, Cass Carter, who've had such an impact on who I am and how I show up in the world. And I've left such an impression. And have modeled to me what it means to be a leader. You know, a business owner, a compassionate person, a kind human, generous human. My mother and my father, my sister, my brother, like people who have just supported and surrounded me in both hard times and really good times. And I wouldn't be where I am today without them. And I mean, I'd be remiss to say without my team. I don't do this work alone, Kelli. This company has been built. From day one with my sweet human saying yes to a baby startup like Amanda or Sammy and our executive team now who are just killing it every day. And they are showing up to make sure that this is a service that is available and accessible and providable to all women and their families. And I'm so grateful for that.
Kelli - 00:30:36:
Awesome. Well, thank you, Amy. I really appreciate your time today and joining us, sharing your experiences, building Mamaya Health and the work that you and your team are doing. You're exactly right. It's a collective effort from community to community to community. It's. It's, we're not in a silo. It might feel like it, but we can't ever be like, we can't ever work in a silo because. There's less impact that way to put it plainly, honestly.
Amy - 00:31:10:
Truly. Well, and right, I mean, Kelli, like, like women's health issues didn't get shattered in a silo, right? Like one person or one system didn't disrupt that. That's because multiple things have failed us. And so it's not going to be solved. And that's, I mean, Kelli, when I get humbled again, it's like, it's not, I'm not going to fucking solve. I'm not going to solve this. It's not going to be solved by me. It's going to be solved because so many people who align in their vision and their hearts come together. It's not about ego. Because, so many people drop their ego and come together and say, this has to be different. And I'm here to do that all day.
Kelli - 00:31:46:
Awesome. Well, Amy, I am going to say thank you.
Amy - 00:31:51:
Kelli, thank you. You're a precious human.
Kelli - 00:31:56:
Thank you, Amy, for taking the time to join us today to share your experiences. And thank you all for listening. For more podcasts, videos, blogs, and maternal health content, visit the Maternal Health Learning and Innovation Center website, maternalhealthlearning.org. You can also subscribe to our YouTube channel and follow us across all social media platforms. Tell us what you want to hear more of, review our podcast, and share with other like-minded innovators. We've got some great episodes recording now. Be sure you're subscribed and let's keep talking. Tag us in your post using #maternalhealthinnovation. I'm Kelli Sheppard, and we'll talk to you again soon on the Maternal Health Innovation Podcast.
Disclaimer - 00:32:51:
This project is supported by the Health Resources and Service Administration, HRSA, of the U.S. Department of Health and Human Services, HHS, under grant number U7-CMC-33636, State Maternal Health Innovation Support and Implementation Program Cooperative Agreement. This information or content and conclusions are those of the author and should not be construed as the official position or policy, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.