Latest / Becker's Healthcare Behavioral Health / Expanding Trauma Informed Mental Healthcare for Mothers, Infants, and Families with Dr. Obianuju Berry

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Expanding Trauma Informed Mental Healthcare for Mothers, Infants, and Families with Dr. Obianuju Berry · Becker's Healthcare Behavioral Health

• 0:00
  My name is Rosie Talaga with the Becker's
• 0:02
  Healthcare podcast. I'm thrilled today to be joined
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  by doctor Uju Berry, medical director of NYC
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  Health and Hospitals maternal, infant,
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  and domestic violence mental health services.
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  Doctor Berry, it's a pleasure to have you
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  on the podcast today. Oh, thank you so
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  much, Rosie. I'm happy to be here. We
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  have a great conversation in store looking at
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  the opportunities and headwinds that are making an
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  impact right now and looking ahead to how
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  these might shift in the future.
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  Before we get into it, doctor Berry, can
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  you please take a minute to introduce yourself
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  and tell us a bit about your background?
• 0:34
  Absolutely. So hi, everyone. So as mentioned, doctor
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  Berry.
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  So I am serving as the new inaugural
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  role of New York City Health and Hospital's
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  maternal, infant, and domestic violence mental health services.
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  Honestly, this expanded role really just encapsulates
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  all my many years of training, fifteen plus
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  years of training as a child psychiatrist,
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  reproductive psychiatrist, trauma expert, and researcher who does
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  a lot of work, bridging the gap between
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  maternal and infant health and behavioral health and
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  reducing,
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  any types of morbidities from trauma.
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  So in this new expanded role, I'll be
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  able to support system wide initiatives at New
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  York City Health and Hospitals to strengthen mental
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  health care for pregnant and postpartum individuals as
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  well as their infants.
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  And in addition to kind of continue my
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  services, working closely with the city to,
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  bring in mental health access to our DV
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  domestic violence shelter systems and New York City
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  family justice centers as well. And I also,
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  as an aside, do teaching classes, see patients,
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  teaching classes at NYU where I'm an associate
• 1:37
  professor,
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  and then serve as medical director and principal
• 1:40
  investigator on two,
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  national grants. One is a healthy brain child
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  development study, and the other one is a
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  SAMHSA funded national child traumatic stress network project.
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  So keep my hands busy, keep myself busy,
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  but really excited to be in this role
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  and to really support our New Yorkers.
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  Thank you so much. Yes. You do seem
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  like you're keeping busy.
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  Great, great experience, fifteen plus years, and I'm
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  really looking forward to learning more about everything
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  you've learned along the way.
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  So to start us off,
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  we know we're in such a formative time
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  and wrapping up the year in just a
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  couple weeks. As we're looking ahead to 2026,
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  what opportunities and headwinds do you have your
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  eye on right now?
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  Yeah. Absolutely. So I am you know, it's
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  really as we close at twenty twenty five,
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  a lot has happened in 2025.
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  And I'd be remiss to not talk about
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  somewhat or at least mention some of those
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  challenges that many of our patients and our
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  clients face in terms of just decreased access
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  to mental health care.
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  But I am really hopeful for 2026
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  and what that brings.
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  I mean, optimistic
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  about the shift,
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  towards more integrated community centered care, which is
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  where the bulk of my programs really rely
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  on.
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  Really just breaking down silos across systems, across
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  agencies, across disciplines,
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  really treat our New Yorkers who are impacted
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  by behavioral health or other types of traumatic
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  events.
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  And we see this with signals that are
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  happening from New York State office of mental
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  health where there's just been this real big
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  push towards
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  collaborative care models and really integrated care,
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  to really think holistically
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  about,
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  maternal care, infant care, and trauma and, trauma
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  informed services.
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  And so really thinking about
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  riding this momentum and navigating some of those
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  headwinds as we as we articulated to kinda
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  ride the wave,
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  despite what's happened, really kinda learning from what
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  those gaps are.
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  And in particular, some of the areas I'm
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  interested in is really thinking about our staffing
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  and retention
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  for these type of services,
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  really trying to invest the money in the
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  workforce to be able to work with,
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  be able to provide high quality clinical care
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  to our, to our New Yorkers. So New
• 3:55
  York City Health and Hospital serves over a
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  million New Yorkers a year, and people come
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  from all walks of life. And so how
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  can we take care of them? And that's
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  really by supporting our workforce and supporting our
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  staff to do so.
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  And then also really thinking about,
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  you know, taking a really deeper eye into
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  some of those disparities that we're seeing in
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  maternal mortality and trauma informed care,
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  and really addressing some of those those structural
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  barriers,
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  and really thinking about how can we decrease
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  those rates of maternal mortality and morbidity,
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  and really supporting our survivors as much as
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  possible who are asking for help, who want
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  the help,
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  and how we can really kind of push
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  New York City Health and Hospitals to be
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  the bread and butter of those a million
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  New Yorkers and more who come into our
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  city.
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  Absolutely. I think that's super refreshing to hear
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  your optimist
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  take regardless of, like you said, the different
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  challenges and decreased access to mental health care
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  that's gone on this year, but really, like
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  you said, riding the momentum and riding
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  that wave of the headwinds despite what's happened.
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  And moving forward, it's really refreshing to hear.
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  Yeah. I'm a glass half full person.
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  That's wonderful. We need more of those people.
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  I think something that goes hand in hand
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  with looking ahead and moving forward is discussing
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  growth. So I'd like to ask, how are
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  you thinking about growth and adding value to
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  your organization?
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  You know, I think that's such a great
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  question to ask because, you know, whenever you're
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  in the work of public health, you always
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  gotta think about growth and adding value,
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  and particularly
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  make making sure that the work you're doing
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  is serving the population that you're trying to
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  serve. And if not, then you need to
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  grow and add more value. So these those
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  two components are so crucial to how I
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  think about the work I do.
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  And so when I think about the growth,
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  a lot of times people think about it
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  as scaling up. You might have heard the
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  term scaling up, and that's absolutely true.
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  So right now, we wanna we have the
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  our work in these shelter services and in
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  the FGCs, but are we missing other people?
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  So we wanna scale up, and I'll talk
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  a little bit more about that. In addition,
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  while they're scaling up, we also don't wanna
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  lose sight of value and the quality of
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  work. And so I also view this as
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  deepening the quality of the specialized care I
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  do bring to vulnerable populations.
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  So for the first part, growth. Really, it's
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  really expanding the reach of specialized care using
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  this model that my team has created called
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  the siren model,
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  which really stands for universal screening, identification,
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  increased referrals, and education.
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  And particularly, this model can be applied anywhere.
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  And what we're doing right now is we're
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  applying this model to thinking about integrating early
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  childhood mental health into nontraditional
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  settings.
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  We've already been able to establish that by
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  introducing,
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  mental health services into non traditional settings. So
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  my work in the domestic violence shelters
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  as in the 41 domestic violence shelters that
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  we're in and in the five family justice
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  centers
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  was the first time in the country that
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  a city had taken a systemic approach to
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  meeting families where they feel safe.
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  So instead of having families come into the
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  hospitals, which is usually how we think about
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  mental health care, medical care is being served,
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  our team actually goes directly
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  to the families in those advocacy centers and
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  in the shelters that they're in, making sure
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  that when they feel safe physically, we'd also
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  make sure that they feel safe mentally.
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  But what we noticed,
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  when we're there is that many of the
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  services were geared towards adults,
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  which is great. We wanna make sure the
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  adults are being taken care of.
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  But what we did realize is that many
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  of those adults are coming into care because
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  they also wanted help for their children, and
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  particularly that very vulnerable, very young children, the
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  zero to five age group. And so we
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  kind of pivoted. We really went from adult
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  centered model to think of it as family
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  centered model and really integrating early childhood mental
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  health into these nontraditional
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  settings. And so what I hope to do
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  is grow and scale this model of thinking
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  about taking care of these, again, screening, identification,
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  referrals, and education
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  into nontraditional settings and really thinking about system
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  change when we do that.
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  So that's number one. But number two, again,
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  how do we
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  grow without actually, you know, not serving those
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  families and really think about sustainability and really
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  thinking about the quality of work.
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  And so what we wanna do is really
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  strengthen those interagency
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  collaborations.
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  Again, when you're going into a nontraditional
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  medical setting, there are agencies that may speak
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  a different language than we do. And so
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  how do we, invest in communication? How do
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  we strengthen those relationships?
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  And how do we empower people in those,
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  arenas to be able to really think about
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  providing the best care to those who are,
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  in those
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  settings. But, ultimately, the greatest value that we
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  can actually provide is just breaking that cycle
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  of intergenerational
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  trauma.
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  And by intervening early and really thinking about
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  prevention and really thinking about family
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  care, to hopefully change long term health trajectory,
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  for all our families in New York.
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  Those are great, great,
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  insights.
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  I think a common theme with what you're
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  saying is, meeting the patients where they are,
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  whether that be
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  ensuring they're physically and mentally safe by meeting
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  them at their advocacy centers or their shelters,
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  but then also meeting those places that you're
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  meeting at, the advocacy.
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  Like you said, they might have different languages,
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  meeting them where they're at as well with
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  that common communication to really be able to
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  work with them and provide the needs that
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  the community
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  is in need of.
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  You're absolutely right, Rosie. That was such a
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  nice synthesis of what I just said. So
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  absolutely right.
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  So looking ahead, I think
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  we're living in such a transformative, fast paced
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  world, which can be very beneficial and exciting,
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  but sometimes the hardest
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  part of change is figuring out what change
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  to make. So I would love to hear
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  your take on what you think a risk
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  or investment
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  that's worth making this year.
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  Absolutely. So I think those those two points
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  go hand in hand. So whenever there's risk,
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  we also need to think about there's a
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  gap, and so we definitely need to invest
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  in making sure that gap no longer exists.
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  And that risk or that gap that we're
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  thinking about is investing heavily in specialized mental
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  health care,
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  that's collocated in a nontraditional setting and really
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  thinking about the very young children that are
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  in need,
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  who are in these spaces who rely so
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  heavily on adults in their arena.
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  And, historically, the risk was perceived as that
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  if you're focusing so much on the young,
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  you may not be able to see the
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  results.
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  But what we do know is that
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  the for every dollar that is spent invested
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  in early childhood mental health, we do see
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  return of up to $13 in long term
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  savings in care.
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  In addition, there's a risk of not doing
• 10:50
  anything. There's a cost of silence that happens
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  when we go when we leave these early
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  children and young children to be neglected.
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  You know, somewhere up upwards of these children
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  who get neglected, they become adults.
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  And these adults,
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  who do who are not investing too early
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  in their education, their behavioral health can lead
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  to cumulative costs in the society, leading to
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  the lost productivity,
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  leading to losses of wages, leading to more
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  types of money that's put in the very
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  tail end as opposed to putting in the
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  money now. And so the investment is really
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  just thinking about prevention and early prevention as
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  much as possible.
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  And, again, thinking about the siren model. How
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  can we do universal screening so it's not
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  just the squeaky wheel gets the grease, but
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  everyone gets identified early on and gets targeted
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  treatment that really helps them and referrals to
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  cases that really make plan
• 11:41
  areas that really support their needs. And then
• 11:43
  really kinda educating the public around, the value
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  of,
• 11:48
  these type of interventions.
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  And, ultimately, really thinking about
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  creating a system that we can find target
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  the early children in the areas where, as
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  you mentioned, where they feel safe and where
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  they are, bringing the values, bringing the care
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  to where people are.
• 12:03
  Absolutely. That's that's a great, great call out
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  that the investment worth making is for prevention
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  and specifically early prevention,
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  which goes back to what you said earlier
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  about how traditional models were more adult centered.
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  And I was moving to are you trying
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  to make it move more towards family centered
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  models,
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  which is really important to focus on the
• 12:23
  youth because one day, the youth will be
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  the adults that you'll maybe not have to
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  spend,
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  the resources and time on if they got
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  what they need when they were younger. That's
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  great.
• 12:33
  Yeah. 100%.
• 12:35
  So so for our last question, I'd like
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  to hear about
• 12:39
  dive in a little deeper to the predictions
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  for the future. Whether you're thinking more short
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  term or long term, where do you see
• 12:46
  the best opportunities for growth in the future?
• 12:50
  Yeah. So I think the two areas I
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  see that best opportunities for growth is really
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  shifting, as I mentioned, shifting this model
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  of being reactive,
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  so to being preventive.
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  So instead of waiting for our adults to
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  get sick, why don't we treat the kids
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  when they're young? We know that the earliest
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  signs of anxiety and depression actually starts in
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  adolescence.
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  And so maybe we can start there. Sometimes
• 13:15
  we can even start earlier on, like, so
• 13:17
  during, infancy and toddlerhood.
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  And in fact, actually, some of my research
• 13:22
  showing that,
• 13:24
  pregnant women who actually feel stress themselves can
• 13:27
  actually impart some of that stress to the
• 13:29
  babies in utero.
• 13:31
  And so, again, that's another preventive measure. So
• 13:33
  starting early on, so shifting of dial to
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  start early,
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  that and and I think that's a great
• 13:40
  opportunity because, again, we put investors dollars in
• 13:42
  now,
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  then we'll be able to have a bigger
• 13:45
  risk,
• 13:46
  return on our investment later on.
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  And the second area of growth is really
• 13:51
  thinking about nontraditional
• 13:52
  settings.
• 13:53
  There's so many so much research is going
• 13:55
  on right now where we see people want
• 13:58
  people want care. It's hard for them to
• 14:00
  access care. And when you think about particular
• 14:02
  areas where there are food deserts or there
• 14:04
  are, you know, hospital deserts, you know, maybe,
• 14:07
  like, coming to the hospital is not the
• 14:09
  the best answer for people.
• 14:12
  We also may think about the cost of
• 14:14
  them traveling for so long. Like, here in
• 14:16
  New York City, you know, sometimes you could
• 14:17
  be on the subway for hours just to
• 14:19
  get to an appointment, and that's lost time
• 14:22
  in New York wages.
• 14:23
  And so just as we've learned how telehealth
• 14:25
  can be so advantageous to those families, we
• 14:28
  can also think about shifting the dial from
• 14:30
  the medical model to thinking about it being
• 14:33
  in the community.
• 14:35
  And so this
• 14:36
  the idea is to really kind of grow,
• 14:39
  our future to becoming, like, a seamless safety
• 14:41
  net,
• 14:42
  where our city can actually support everyone no
• 14:45
  matter where they are and where they can
• 14:47
  get care,
• 14:48
  to be able to prevent care, prevent the,
• 14:51
  the the the ongoing sequalae of or consequences
• 14:55
  of, any social determinants of health, but also
• 14:58
  apply them to the communities where people are
• 15:00
  at already.
• 15:03
  Those are great takeaways. I think those two
• 15:06
  examples of the opportunities in the future, one,
• 15:09
  that shifting model of
• 15:11
  from being reactive to preventative.
• 15:15
  Don't I loved your quote of saying don't
• 15:16
  wait for adults to get sick. Treat case
• 15:18
  when they're young.
• 15:20
  Even very interesting about the feelings of stress
• 15:23
  possibly being passed on even during pregnancy.
• 15:26
  And then the nontraditional settings, again, people want
• 15:29
  care. It's hard for them to access care.
• 15:32
  And just because
• 15:34
  what's best for one person or population, it
• 15:36
  doesn't mean it's universal.
• 15:38
  Going back to your your statement of saying
• 15:41
  you work in public health, you need to
• 15:42
  serve the population that you're trying to serve.
• 15:45
  It's different for everyone, so that's really, really
• 15:47
  inspiring. Thank you.
• 15:49
  Yeah. No. Thank you.
• 15:51
  That is the end of our discussion today.
• 15:54
  Thank you so much, doctor Ujibari.
• 15:57
  It's been a pleasure talking with you and
• 15:59
  hearing about all the amazing things you're doing
• 16:01
  at NYC Health and Hospitals,
• 16:04
  and we hope to collaborate with you again
• 16:06
  soon. Oh, I look forward to that, Rosie.