Lissette “Mitzy” Liriano spends a lot of time holding hands, she says. As Chester County Hospital’s first, and only, maternal mental health specialist, Liriano spends nearly all her time at the hospital working in its OB-GYN clinic, which offers reduced-rate gynecological and prenatal care and childbirth deliveries to ensure access to such services for patients without health insurance.
The pandemic brought a flood of new patients to the clinic, Liriano says. The recent closure of two other hospitals in Chester County has brought another wave, and many of these patients have mental health concerns, according to Liriano, who started working at the hospital in 2015 as a childbirth and breastfeeding educator. She began dividing her shifts among the hospital and clinic the next year and was appointed maternal mental health specialist in February 2018. Liriano says the position was established to help meet a growing need at the hospital, particularly in the clinic, where a majority of patients are Hispanic. She estimates at least three in five of these patients are struggling with their mental health.
“I’m seeing anxiety, depression, and perinatal and postpartum mood disorders,” Liriano says. “Many are victims of physical or sexual abuse, either currently or when they were children.”
Liriano says the clinic is often their first exposure to medical care of any kind, let alone mental health therapy, which is stigmatized among many Hispanic cultures.
“Many of these patients aren’t able to, or won’t, get the help they need, so their suffering becomes this constant pain that follows them everywhere and gets bigger and bigger,” Liriano says. “Even if they do manage to bring it up to a provider or nurse, where do they begin? In the best-case scenario, they’re experiencing a situational depression that will hopefully improve. But many have been carrying this baggage for years and simply have no way to separate themselves from it.”
Liriano works closely with a number of local agencies, including, but not limited to, the Chester County Department of Health’s Nurse-Family Partnership, the Chester County Maternal and Child Health Consortium, and West Chester University Community Mental Health Services, to help her patients find long-term care and other valuable resources, like assistance with signing up for health insurance.
Since 2018, Liriano has led a support group at Chester County Hospital called Moms Supporting Moms, which meets on the second Thursday of each month. Attendance has grown a little with each new meeting as the group develops a following, and the regulars tell their friends to come. “Bring your baby if you have to,” they say. With the onset of the pandemic, Liriano moved the group’s meetings online.
She is armed with discussion topics—spotting the signs of anxiety and depression, how to ask for help—but she prefers to empower the parents in attendance to dictate the course of the sessions.
She sees Penn Medicine as the outlier because its leaders and providers appreciate the value of tending to their patients’ mental and emotional health. Maternal mental health isn’t a new specialty, she says, so much as it’s overlooked and underfunded. Across Penn Medicine, hospitals and care teams have been making concerted efforts to improve maternal health outcomes and reduce racial and ethnic disparities with a systemwide, multipronged approach that encompasses research, clinical care, and community engagement. Having experts to specialize in maternal mental health supports that larger goal.
Read more at Penn Medicine News.
