Podcast Transcript:

Dani: Hello, and welcome to today's episode of the OviaAsks asked podcast. I'm Danny Bradley, Director of Clinical Services and Evidence for Ovia Health.

Today we're going to be taking on a new topic in our conversation and actually discuss some of the research that we do here at Ovia specifically on the topic of mental health. Parental pressures during the pandemic and we're going to be hearing from one of our very own mental health coaches about ways that employers can better support parents and help to alleviate some of their stressors and concerns that have come up during the pandemic, as it pertains to returning to work and working remotely.

If you didn't know, Ovia health has helped over 15 million families in their path to women's maternal and family health. That is a lot of families and we're very fortunate to have a very active member base. In addition to helping these families along their pathway to parenthood, whatever that might look like for them, we also do a lot of our own research. Some of that research we do in house with our own team of data scientists and some of that is done in collaboration with many of the leading universities around the country, and even around the world, the topics of our research span everything from mental health, which we'll talk about today to the cesarean epidemic in the United States to fertility services.

Today, like I said, we're diving a little bit deeper into our own research on the topic of parental mental health and, specifically, how employers and organizations can better support working parents more holistically, taking into account behavioral health. We are fortunate enough to have Tamika Simpson with us today. 

Tamika is a registered perinatal mental health specialist and a board certified lactation consultant. She's also one of our very own digital health coaches at Ovia so welcome to meet them, 

Tamika: Yes, thank you very much. I'm happy to be here.

Dani: It’s wonderful to have you. Can you just tell us a little bit more about yourself and your work Tamika?

Tamika: Sure, so I originally have my masters in public health and I'm a board certified lactation consultant. So that led me to working with a lot of different parents with a lot of different needs and I discovered that there was a huge need and lack of resources for mental health.

Which is when I decided to go back to school. And I'm now certified as a perinatal mental health specialist and I'm finishing my doctorate in clinical psychology this year.

Dani: That's amazing and we are so lucky to have you on the team.

As we both know mental health is such an important topic to cover, particularly when we're thinking about health outcomes and how we're supporting all of our members every day.

 I think it's gotten a lot more attention since the start of the pandemic and parents were, of course, particularly vulnerable to the effects of mental health concerns during the pandemic. And so, you know I know we've talked about this in the past week, but we ran a really interesting study in late 2020 into 2021, that we were able to present the results from at the American Psychiatric Association conference this year in the spring of 2021. 

The results of that study actually illustrated the impact the results of that study actually illustrated the impact of the pandemic on parental mental health and well being. We didn't just measure the change in mental health status pre and post pandemic, but we were also able to uncover what it was that was kind of triggering stress and worry among parents and using this information. 

We saw tangible outcomes that came from that research that leaders can start to figure out how to evolve their support programs and the benefits that they offer to better fit the new needs and reality that working parents are experiencing now.

You know, none of these results are terribly surprising, but we did see some interesting things like stress levels actually change, depending on the number of children in the house. As the number of children increases, so does the level of stress expressed by the parents in that house. We found that top concerns among all parents, regardless of number of children, were:

1.  transmission of the coven virus, as the first concern.
2. Child care closures returning to work 
3. concerns about developing postpartum depression and other mental health conditions
4. and then the last top concern was around job security and finances.

Since we ran that study in 2020 and into 2021, a lot has changed. We ran this same study again much more recently, actually just as of June 2021, and have collected more data on these same outcomes. Now that we're 16 months past the start of the pandemic, things have changed quite a bit.

Those top parental concerns have shifted slightly now, it looks like the top concern is actually about children being socially isolated.

The next concern is transmission of code and so that has dropped from number one down to number two I think likely in part due to increased access to vaccines, at least among parents, certainly not among children of all ages at this point. 

The next concern is about access. Access to support services like lactation consultants, therapists, and new parent groups. Tamika, I'd love to hear what you think about that as being an IBCLC lactation consultant yourself.

I think one of the most impactful results of this next iteration of the study was that 31% of parents were concerned about perinatal mental health concerns. I know we've also seen a lot of concerns around access to screening for those mental health conditions that are common during the perinatal period, recognizing that a lot of appointments were either cancelled or changed in some way, altered to maybe me virtual or telephonic, and so a lot of parents are concerned about having their their mental health concerns go unnoticed.

So Tamika, do these answers resonate with you? Do they reflect kind of the same things that you're hearing from parents in your day to day work?

Tamika: Oh yes, absolutely, these are the same things that I'm hearing every day. The same concerns, these same situations, that people are just trying to figure out. So many of the parents I work with have been trying to juggle childcare and working from home and distance learning for many of the children who were not back in school, yet.

And there just hasn't been much time for many families to adjust. As soon as they get adjusted, things change again. And so they're just constantly shifting and trying to figure out what's going to work for them.

It's causing quite a bit of anxiety for people, and employers can play a role in relieving some of that stress. Oftentimes employers don’t think there’s much they can do, but we’re hearing there’s a lot to help with. 

The study reported that access to support services like lactation consultants and therapists, as well as working from home with children in the house were prevalent concerns for parents with up to three children. 

And I regularly hear parents talk about the concern over returning back to work on site and their children returning to school. 

We still have that fear of transmission too, that hasn't gone away. Yet, despite infection numbers dropping, many want to continue working remotely, but their offices may not be allowing it anymore or not allowing the same flexibility that they were during the heat of the pandemic. 

Some people are still reporting childcare as an issue. Some have daycare and others are struggling to find it. People may not think about this, but some daycares have closed, and some still have reduced capacity. So, some people are still trying to manage going back but aren’t able to find quality daycare for their children.

Also, many people lost their jobs during the pandemic and are searching for new ones, or needing to find new childcare arrangements. 

Basically, people are dealing with a ton of stress and it's important for employers to remain flexible, as we're still all trying to figure things out.

Dani, I haven't read the findings of the APA study in a while. Are there any differences found between the highest concerns or stress levels between parents with a few kids versus parents with a lot of children? 

Dani: Yeah that was one of the most interesting findings in the study. We found stress levels increased with the number of children in the household to a point.

But, once you reach parents with 4+ children, stress levels actually can drop back down. So people with the most children in their house have fewer concerns, less reported stress. But stress didn’t level off until 4 children, and there are plenty of hypotheses about why that might be the case, but it is a really interesting finding.

Tamika: Yeah that is interesting. Were there any other interesting results, other than concerns over child care? I know there were other family impacts during the pandemic like spikes and intimate partner violence.

Dani: Yes, definitely while there's been a documented surge in reports of intimate partner violence during the pandemic.

Safety at home was actually not one of the top reported concerns by this sample of people who responded to our survey, thankfully. That doesn't mean that it wasn't the experience of many people who are part of the Ovia Community, and there's a lot that we're doing to make sure that those people are supported and have the resources that they need. 

But, thankfully, the relationship with partners and then safety at home, was not one of the top concerns reported.

Tamika: Yeah, and I know your team has done a lot of research on that, as well as the impact the pandemic has had on parental mental health. Beyond this, one does that data show any other trends? Are there any groups who were or are disproportionately impacted?

Dani: Yes, definitely So in addition to the surveys that we've been talking about specific to COVID, we also screen all of our members in our apps, using validated Depression and anxiety screening tools. 

So, the PHQ9 is what we're using in our fertility solution and the Edinburgh postnatal depression scale or the EPDS, is what we use in our pregnancy and parenting solutions. Those are the same validated screeners that clinicians are using in their offices to screen patients for risk of depression. 

We've actually been using these screening tools in the apps for several years, so we were able to do a really fascinating pre and post code analysis and so what we found was that the EPDS scores in general are higher during the pandemic than they were before. 

We're seeing the greatest increases in scores and suicidal ideation, which is one of the items on the screening tool, among women aged 35 to 39 and among women in the BIPOC community, especially black mothers and people who are first time parents. So it's clear mothers are struggling and really parents in general are struggling.

Their employers and their health plans should really be focusing on new programs and benefits that can help alleviate these new pressures or exaggerated pressures of parenting that have popped up during the pandemic and invest in longer term benefits that can ensure their workforce is adequately supported into the future as well. 

We know there's a new normal and we need to adjust the support that we're providing based on what that looks like. Our research found that among parents who voluntarily chose not to return to work or who quit their job during the pandemic the top reasons for doing that were: 

1. Not feeling safe returning to work due to risk of transmission of the virus 
2. not feeling safe with their options that are available to them for childcare.
3. Not having child care at all, 
4. 25 - 30% of people were too stressed and needed more time just before returning back to work, 
5. and then postpartum anxiety and depression was also listed among about a quarter of women.

And, speaking of postpartum stress and these anxieties, I’d love to hear your thoughts. I wanted to ask you as a provider you're talking to parents, day in and day out and you're hearing what's really going on in their lives, and what they're concerned about. What advice and resources would you give to employers who want to help parents who are struggling with these things? How can they help to alleviate these concerns?

Tamika: Well for the parents I usually tell them to talk to their employer, a lot of parents don't want to admit to their boss, or to their company that they're struggling. It could be a pride thing or maybe there's a fear of retaliation. 

What I often hear is that they're afraid of being seen differently than other employees. I think it's important that parents don't feel like they have to hide their kids or their parenting responsibilities. If you are an employer, there are some things that you can do: 

1. Make sure your space is actively talking about parenting. 
2. Encourage managers to talk about it, especially if you have fewer parents in your department or team, because they may be too afraid to speak up or speak out about any issues that they're experiencing.
3. Encourage people to bring their whole selves to work. 

If employees feel like they have to hide something, it impacts the way that they're going to engage at work. It has and will cause people to consider switching jobs. Retention is important for employers, but support is also important for employees.

And that’s one of the things that I just absolutely love about this company (Ovia). We can be having a meeting and someone's kid will randomly pop into the screen and it happens often and no one flips about it, there is no negative response.

There is an understanding that yes, some of us are parents, but that doesn't mean that we aren't able to work and do our jobs well. We can multitask if we need to. We can be parents and employees and our lives don't just stop because we've clocked in. And having that support from an employer personally for me just makes me never want to leave.

It tells me that the company cares about me, not only as an employee, but as a person, and that means everything. More companies need to get on board with that concept, because the reduction in stress is likely to cause an increase in productivity.

Dani: It's such a good point and I think the movement towards bringing your whole self to work and not being afraid to show that. Like you said, your life doesn't stop just because you've clocked in. You're still a parent and oftentimes your kids are home with you. Recognizing that we can support each other in that balancing act of working and being a parent is so important. 

You talked about the role of stress reduction and all of this, so can you talk to me about the role of stress in being able to support parents? What kind of toll does stress take on physical or health related complications? Why is it so important that we focus on reducing these stressors?

Tamika: Yeah, so obviously it's the right thing to do. But it’s more than that. We want employees to feel cared for and we want them to feel supported, but also from the employers perspective, it promotes higher productivity benefiting the employer.

And when we don't do that, people keep going and keep trying, but it actually costs the company money because their employees are not mentally there. It also helps employees to know that you care. That goes a long way in terms of retaining people and retention is everything, right.

So, even if your employees don't need the help today they'll remember that that help is there and that it exists. Just knowing that help is there, and you have something to lean on can be an incredibly powerful tool for employees.

And it may also help you to attract new talent and those who have had bad experiences with other organizations that maybe aren't as family friendly, especially during the pandemic. They may be seeking out a more empathetic and reasonable employer now, and you can be that for them.

Dani: That's such a good point you know we hear, time and time again, especially among people who are of childbearing age and are starting families.  They really care a lot about the benefits being offered to them, and that includes flexible schedules and remote working.

And that that really makes a difference to people when they're doing their job search or deciding if their employer where they're currently working is the right fit for them. What do you most commonly hear from parents that you don't think many employers know?

Tamika: Hmm, that's a good one.

When employers are accommodating and offer family friendly benefits and policies, they're making it clear that they care and that they understand that both family and employment are important, and they're not asking for them to compete. 

Which, I personally think, is so very important and valuable. It becomes really complicated for families to be asked, “which is more important? Your job or your family?” 

That’s unfair to ask of anyone. So, not asking them to compete lets people bring their whole selves to work. It allows them to feel comfortable and confident, and more loyal and dedicated to their job. 

And, because of that flexibility and understanding, these employees are likely to be less stressed, which is going to mean happier and more productive employees.

Dani: So true! Are there any other silver linings that you see? Obviously the pandemic changed our lives, as we know it, but I think it also shed a light on really important topics like mental health and the role that mental health plays, particularly for people who are working and working parents. What do you think some of the silver linings may be here?

Tamika: That's a great point. I think that we have seen the world in a different way. 

I'm thinking and I'm hopeful that parents will be more supported by their employers. I'm hopeful that we'll see more flexible workplaces as the norm, and more diverse family structures being recognized, you know alternative caregiving to older parents, for example. 

'm hopeful and looking forward to seeing mental health being addressed more frequently in the workplace. I hope to see more people investing in solutions that support parents, families and women. And hope that parents will be able to get more balance and support.

Dani: Gosh well, I hope that everything you just laid out becomes a reality for everybody, I think that would make everyone's lives a whole lot easier to navigate and to balance the kind of complexities that everybody's dealing with right now.

Thank you so much for your time and for sharing your insight and your experience working in this really important space, especially during the pandemic, so thank you again for your time and all of our listeners, please tune in to our next episode next week.