Partnering Together to Prevent Perinatal Suicide
Emerging collaborative initiatives designed to address maternal mental health complications across Colorado
Last September, CPCQC gathered with more than 60 national leaders in perinatal mental health to begin developing a PCORI-funded, patient-centered, perinatal suicide prevention research agenda. Suicide remains a leading—and largely preventable—cause of maternal death, yet it continues to be poorly researched, understood, and addressed.
The convening centered the experiences of more than 20 patients and family members affected by postpartum psychosis and suicidal ideation, alongside researchers, clinicians, and other national experts. It sought to balance the need to advance the research agenda with a clear focus on action and impact—ensuring that the priorities identified through the convening would translate into meaningful benefits for patients and families, rather than remaining confined to academic or research settings.
Since the convening, attendees have continued to further national efforts to prevent perinatal suicide. This work feels exceptionally important now, as national rates of maternal death due to perinatal mental health conditions continue to rise and the complexities of postpartum psychosis flood newsfeeds with the Lindsay Clancy mistrial.
Together with our partners, CPCQC remains committed to advancing meaningful improvements to Colorado’s perinatal behavioral health landscape to ensure that all perinatal women and families receive timely, quality, and accessible care.
CPCQC’s new “We All Have a Role” training is one contribution to this work—helping equip a variety of clinical and community-based providers with improved skills to recognize and respond to perinatal behavioral health complications—including perinatal suicidal ideation and psychosis.
From Research to Action: We All Have a Role
We All Have a Role isn’t just a name – it’s also a call to action. Suicide risk is highest in the late postpartum period, which means as obstetric care is ending, risk is peaking. Without a framework for who owns perinatal mental healthcare after the six-week follow-up visit, it’s easy for new mothers to slip through the cracks.
This message compels us to recognize that mental health in the postpartum period doesn’t sit on one provider’s shoulders. It’s a shared responsibility that extends across communities and systems – from clinicians and community-based providers to researchers, educators, advocates, and, importantly, patients and families themselves. Each one of us has a different role to play in reducing preventable deaths related to perinatal mental health.
CPCQC’s partnership with the University of Colorado Department of Psychiatry Prenatal, Reproductive, and Early Childhood Mental Health (PRE) Section on the development of the We All Have a Role course is evidence of what this shared responsibility looks like in action. The CU PRE team has walked alongside CPCQC throughout the development and launch of this new curriculum. They served as conveners for the PCORI gathering, conducted needs assessments across Colorado’s perinatal health landscape, and thoughtfully co-developed the We All Have a Role curriculum for IMPACT BH partners, integrating hands-on coaching and role-play to help providers connect didactic content to real-life situations.
I hope people hear [“We All Have a Role”] as an invitation to act. You do not have to be a mental health specialist to listen without judgment, take a concern seriously, and help someone take the next step toward support. Our specific responsibilities differ, but each of us can help make it easier for someone to speak honestly and receive a compassionate response. That first conversation can help someone believe that help is possible and that they will not have to find it alone. – Dr. Sarah Nagle-Yang, Prenatal, Reproductive, and Early Childhood Mental Health (PRE), Co-Section Head
CPCQC is also partnering with the Community Language Cooperative (CLC) to launch We All Have a Role training in Spanish, increasing accessibility of the curriculum for providers and communities across Colorado. Their translation services are an important part of this work, helping ensure that when we address perinatal mental health, we address it for all patients.
Language should never be a barrier to recognizing warning signs or finding support and resources. By translating materials and providing language access at every point of interaction with healthcare and community resources, we can ensure that community members have access to potentially lifesaving information in the languages of their hearts. – Rosa Guzman-Snyder, Community Language Cooperative, Co-Founder & Principal Consultant
CPCQC and PRE launched a bilingual pilot of the new training this month for our current IMPACT BH cohort across Chaffee, Custer, Grand, Jackson, San Miguel, and Ouray counties, as well as the San Luis Valley. CPCQC aims to expand access to former IMPACT BH counties and additional communities in the near future.
A Growing Education Suite for Perinatal Suicide Prevention
We All Have a Role is just one step in the broader effort to address preventable maternal mortality related to mental health in Colorado. That effort requires coordination and support across systems, as well as champions committed to advancing perinatal suicide prevention over the long term. The Behavioral Health Administration is one such champion, committed to doing their part “to reduce preventable maternal mortality, including investing in programs that work to recognize and effectively respond to the leading causes of maternal mortality, such as suicide and unintentional overdose.”
“The development and recent release of the ‘We All Have a Role’ training is an important and meaningful step forward in ensuring that care teams working with Colorado’s perinatal population are equipped with the knowledge, skillset and resources to effectively support pregnant and newly parenting individuals who may be at risk for suicide.” — Kallen Thornton, Behavioral Health Administration
It also requires continued investment in expanding responsive resources for clinicians. Along with We All Have a Role, CPCQC is partnering with Colorado PROSPER to develop Mental Health is Maternal Health, a clinician-facing, point-of-care decision-support website for perinatal behavioral health. It is designed to help obstetric, primary care, and other frontline clinicians move from screening to further assessment, clinical formulation, treatment considerations, safety planning, consultation, and referral. PROSPER and CPCQC are currently finalizing and piloting the tool, and aim to publicly launch Mental Health is Maternal Health by early 2027.
PROSPER has also launched a new asynchronous course on suicide screening and assessment, Recognizing and Responding to Suicide Risk in Pregnancy and Postpartum. This training equips providers with the tools to conduct suicide risk assessments, develop personalized perinatal safety plans, and identify and address compounding risk factors such as sleep deprivation, isolation, and overwhelm.
The Mental Health is Maternal Health resource and Suicide Risk course join PROSPER’s suite of trainings, tools, and resources for providers, alongside their provider-to-provider warmline for perinatal behavioral health consultation. Together, these tools are intended to help providers assess for suicide risk, and close the persistent gap between identifying a concern through screening and taking meaningful clinical action.
“We are encouraged by the growth of care that meets pregnant and postpartum people where they already are. Integrating mental health services into obstetric, pediatric, and other familiar healthcare settings makes it easier to get support from a team they know and trust. Perinatal psychiatry access programs, including Colorado PROSPER, extend that reach by giving clinicians consultation, education, and help connecting patients with resources. Together, these approaches are building the capacity to address mental health as a routine part of pregnancy and postpartum care.” – Dr. Sarah Nagle-Yang, Prenatal, Reproductive, and Early Childhood Mental Health (PRE), Co-Section Head
Perinatal Mental Health at the Intersections
The recent national focus on postpartum psychosis has exposed how much remains misunderstood about the condition, and perinatal mental health more broadly. It is important that the conversation does not end with the Lindsay Clancy mistrial. Instead, this is an opportunity to better understand what is needed to recognize warning signs earlier, build stronger systems for families, and address perinatal mental health complications before they become a crisis.
Greater awareness of perinatal mental health has helped more people speak openly and seek support. That conversation must also make room for severe illness and suicidal thoughts. – Dr. Sarah NY
These moments do not happen in a vacuum. There are often overlapping risk factors, with experiences such as trauma, health-related social needs, and isolation significantly increasing someone’s vulnerability during the postpartum period. This means that perinatal suicide prevention does not start and end with mental health screenings—there are opportunities across and beyond our systems of care to understand and address factors that increase this risk.
Intimate Partner Violence (IPV) is one place where these risk factors may intersect – in 15% of maternal suicide cases, IPV played a role. Many healthcare providers are unsure how to start a conversation or respond when someone discloses abuse—and missing the opportunity to support a patient could also mean missing the opportunity to prevent a crisis before it happens.
This year, CPCQC partnered with Safehouse Progressive Alliance for Nonviolence (SPAN) to develop a clinical perinatal IPV training. The new course, Building Safety, equips providers with the tools they need to recognize and safely respond to intimate partner violence, helping them build confidence to provide trauma-informed care and identify themselves as a safe place for their patients to seek help.
“When we talk about preventing suicide in the postpartum period, we have to look at what is happening in a person’s whole life—not only their mental health. Intimate partner violence can intersect with depression, anxiety, [and] substance use because of isolation, financial dependence, and fear for the safety of both the parent and their baby. These experiences do not happen in separate boxes, and neither can our response…through initiatives such as Building Safety, we are working to help perinatal providers understand how IPV, mental health, suicide risk, and safety can intersect, recognize when someone needs urgent intervention; and offer support” – Kari Ricard, CPCQC, Clinical Quality Improvement Program Manager (SPARK)
And when firearms in the home contribute to high-risk situations involving suicidal ideation and intimate partner violence, suicide prevention also extends beyond the clinical walls to anyone who plays a role in firearm safety.
This is what We All Have a Role looks like in action. Suicide prevention is not about one singular moment, one clinical encounter, one individual provider. It takes all of us: from the leaders at the PCORI gathering, to the researchers at the University of Colorado, from the translators at the Community Language Cooperative to the advocates at SPAN. Perinatal mental health is complex, and will require us to work together across systems to better understand how to prevent crises before they happen. As we look back on Suicide Prevention Month, We All Have a Role is an invitation to consider what your own role is in this work. There is still a lot of progress to be made, but if each of us is committed to showing up, learning from one another, and educating others, we can make a meaningful difference in the lives of perinatal women and families in Colorado.
