Placement: Columbia University Vagelos College of Physicians and Surgeons
Mentor: Catherine Monk, Ph.D., Diana Vagelos Professor of Women’s Mental Health, Department of Obstetrics & Gynecology; Professor of Medical Psychology, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons
Co-mentor: Nancy Byatt, D.O., M.S., M.B.A., Professor of Psychiatry, Ob/Gyn, and Population and Quantitative Health Sciences, UMass Chan Medical School
Project: Exploring Racial Inequalities in Maternal Mental Health Outcomes
Claire Wilson, MRCPsych, PhD, is a 2023–24 U.K. Harkness Fellow in Health Care Policy and Practice. She is currently an Honorary Consultant Psychiatrist and Research Fellow at the Institute of Psychiatry, Psychology, and Neuroscience, King’s College London and South London and Maudsley NHS Foundation Trust.
Claire employs a lifespan approach to the development of healthy and resilient families. In her clinical practice she supports perinatal people and those planning for pregnancy in the community of South East London. Her clinical work and research focus on the intergenerational transmission of risk for mental health and disease and opportunities for intervention to prevent adverse developmental trajectories.
Claire’s areas of focus include the preconception and perinatal periods and, although she is an epidemiologist by training, she uses a range of methodologies to translate her work from the level of the bench or the database, to the bedside, to policymakers, and to the public. This includes policy-oriented and clinically relevant evidence synthesis and codesign and evaluation of complex interventions.
She is particularly interested in how parental multimorbid physical and mental ill health and substance misuse come together in the preconception and perinatal periods to shape offspring outcomes across generations. During her Harkness Fellowship, she investigated the influence of racial inequalities on parental mental health outcomes.
Project Overview: Perinatal mental illness affects around 1 in 5 birthing people globally and is associated with adverse outcomes for those affected and their families. Such adverse outcomes are not inevitable and there is now good evidence for a range of both preventive and treatment interventions. There are well-documented inequalities in mental health outcomes across a range of social determinants, including race; such inequalities are also apparent during the perinatal period. There are also racial disparities in mental health care delivery during the perinatal period.
Racial inequalities in perinatal mental health are now being recognized as key policy priorities in both the United States and the United Kingdom. In the recent White House Blueprint for Addressing the Maternal Health Crisis, a commitment was made to expand the Safety Program in Perinatal Care to address these inequalities. Likewise, in England, the Department of Health and Social Care’s Maternity Disparities Taskforce has been established to focus on the health of ethnic minority women in response to the findings of the Women’s Health Strategy published in 2022.
Using routinely collected epidemiological data, this project will investigate the drivers of these racial inequalities in access to perinatal mental health services and associated maternal and child outcomes. It also will utilize qualitative approaches to explore current initiatives to reduce inequalities. Findings have the potential to inform the development of culturally sensitive interventions to promote equity in this area for underserved populations.