Bright Futures

“Infant mental health? What can you even do with an infant?” This question inevitably came up any time I told people I was planning to enroll in the Infant-Parent Mental Health Fellowship Program, a 15-month training program offered by University of California, Davis. I see so many children in our inpatient psychiatry unit who can stabilize their symptoms while in our care but, upon discharge, face challenges maintaining that stability in an outpatient environment. I realized that to truly support these children, helping them grow a secure and loving attachment to their caregivers would have a much more lasting effect. Many of the parents of these children had suffered trauma of their own, and it was so hard for them to deal with their pain amid the joys and burdens that come with a newborn. This lack of attachment and bonding was detrimental for both the kids and parents, creating difficulties that shaped their lives together. By enrolling in the UC Davis program, I hoped to learn some tools to effectively help both the parents and the child to grow as happy and healthy as possible and to be proactive in our treatment of mental health instead of reactive. – Dr. Danica Denton

My passion for supporting families during pregnancy and early childhood began in a backward fashion. In graduate school I completed a yearlong practicum in hospice care, working primarily with a geriatric population. Most of my patients were nearing the end of their lives and much of our therapeutic focus involved a review of their lifetime. Among the remarkable reflections of personal achievement surfaced frequent recollections of hardship, addiction, regret, etc. Hoping to guide individuals earlier through life’s inevitable difficulties, I then began working with children. As with the older patients, many of the adolescents referred to my practice were already knee-deep in maladaptive patterns of behavior and intergenerational trauma. Soon, I learned that my ideal approach to helping individuals lead healthy and happy lives meant starting from the foundation: the parent-child relationship. I was only beginning to understand the true power of the parent-child connection, which ultimately begins long before the baby is even born. – Kari Millican, MA, LPC

During pregnancy, maternal mental health is of key importance to the growth and development of a woman’s baby. Symptoms of depression during this stage are often misinterpreted for common traits of pregnancy, including lethargy, heightened emotions, and changes in appetite and sleeping patterns. Ongoing research in this area supports that experiences during the prenatal period, infancy, and early childhood influence the trajectory of a child’s life. Thus, social, psychological, and emotional interventions become a critical component of perinatal health. Examples of such interventions include helping treat pre- and postpartum depression, which is so often undiagnosed and ignored, particularly among fathers; showing a mother all the ways her 6-week-old baby is already responding to her movements and facial cues, and deepening that emotional bond; discussing psychiatric medications with a mother who is worried about side effects for her developing child but needs the support for her own health; and preparing families during and after pregnancy for the stress that surrounds a medically complicated delivery and bonding with an infant who needs to spend significant time in a NICU. All these interventions can have a lasting effect on parents and children, leading to happier and healthier relationships throughout the family.

The field of perinatal health is not new. The International Marcé Society for Perinatal Mental Health was founded in 1980, named after Louis-Victor Marcé. Dr. Marcé was a French psychiatrist who published a paper on perinatal mental illness in 1858. The evolution of treatment has continued, as Dr. Zachary Stowe, a psychiatrist and the director of the Women’s Mental Health Program at University of Washington, has said, “I have spent the last 10 years of my career worrying about the impact of medications. I’ve been wrong. I should have been worrying more about the impact of illness.” We at Phoenix Children’s are looking at the effects of not only medications but also of untreated mental illness in pregnancy for the mother and her baby. The golden rule of postpartum support says it best: “Every baby deserves a healthy mother/parent, and every mother deserves to enjoy parenthood.”

The development of the Center for Perinatal and Infant Mental Health at Phoenix Children’s has been based on this understanding. We are eager to promote awareness of the psychological and emotional work women do during pregnancy, increase the understanding and significance of mental health during this stage of life, and impact future generations from the earliest possible moments. Perinatal psychiatry means supporting families through the time before and after pregnancy. The unique part of this clinic is, we will be able to see both the adults and the children, treating them as a unit rather than as separate entities. This allows us to focus treatment in a synergistic fashion that will provide better and longer-lasting outcomes. We are very excited to help meet the needs of these parents, caregivers, and children, helping set them on a path toward a happy and healthy home.

Authors

Danica Denton, DO

Dr. Danica Denton completed her adult psychiatry residency at Vanderbilt University Medical Center in Nashville, where she gained experience working with a diverse patient population. She also completed a two-year fellowship in child and adolescent psychiatry at Vanderbilt, with a focus on patients with developmental delay and early childhood development. She is certified in perinatal mental health. She has also completed an infant mental health fellowship through the UC Davis Infant-Parent Mental Health Fellowship Program in Napa, California.

Kari Millican, MA, LPC

Kari is certified in perinatal mental health and has extensive experience in early childhood psychotherapy. She specializes in infant-toddler mental health and the fundamental aspects of bonding and attachment in the caregiver-child relationship. Kari has also been certified in numerous therapeutic approaches to treat complex trauma, depression, anxiety and other conditions. In her clinical experience with a diverse population, she maintains a strength-based approach with each child and family she meets.