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Why Do the Classes Stop When the Baby is Born?

By: Nathaniel Counts, J.D., MHA Director of Policy and Kelly Davis, MHA Policy and Programs Associate

When you have your first child, you go to classes throughout your pregnancy. The classes help you feel as comfortable as you can be on the big day. But then the classes stop. You might have made it through pregnancy, but now you suddenly have a baby to take care of – and most parents would tell you that this is hardly the easiest part.

So why do the classes stop when the baby is born? Why don’t we equip people for one of the most important jobs they’re ever going to have to do – being a parent.

It’s not that parenting classes don’t exist. Researchers have been working for decades on ways to best support parents, and several of their programs have proven highly effective. Children whose parents participate grow up doing better in school and are less likely to use substances or develop a mental health condition. Parents benefit too. They’re less likely to develop mental health problems, and many find that they end up with new friends and increased support beyond the program.

So while we know that parenting classes work at preventing expensive future health issues, people don’t have access to these programs because we haven’t figured out how to pay for them.  Health care billing was designed for surgeries and diagnostic tests, and these kinds of ongoing preventive supports fit awkwardly into our current framework. One study in Massachusetts found great results when integrating a parenting program into pediatricians’ offices, but the sites weren’t able to continue running the programs once the study was over – there was no way to for providers to be reimbursed.

Mental Health America (MHA) is currently exploring several avenues to reimbursement, so that parents can get access to these programs. We will outline two of the strategies toward reimbursement here.

The first is through the U.S. Preventive Services Task Force (USPSTF). Under the Affordable Care Act, certain public and private health care plans must cover services for which the USPSTF gives an “A” or “B” recommendation. The USPSTF has recommended several behavioral health screenings, along with follow-up counseling. If the USPSTF recommended parenting programs (a form of group counseling) for children, it could prevent and reduce many of the conditions they later screen for.

The second is through the Centers for Medicare and Medicaid Innovation (CMMI). CMMI was also created by the Affordable Care Act, and it has the unique ability to drive reforms in public health insurance by promoting services that improve outcomes and reduce costs – and parenting programs do both of these. Most recently, CMMI is working to increase access to the Diabetes Prevention Program (DPP), which is remarkably similar to many parenting programs. Both involve a series of group sessions to provide behavioral skills to get the best possible health outcome. If CMMI were to consider increasing access to parenting programs in the same way it did with the DPP, more providers would be able to offer them.

Hopefully, soon the classes won’t need to stop when the baby is born, and parents will have access to more support for the hardest job they will have to do. From our standpoint at MHA, this access brings the promise of improved mental health for both parents and children. We would love your help on this effort – please reach out to us at any time at ncounts@mentalhealthamerica.net or kdavis@mentalhealthamerica.net

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This blog post has also been published with permission from the authors on https://www.ffcmh.org

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