The Newark Star-Ledger has just done a report on the status of New Jersey’s "Speak Up When You’re Down" program that I think everyone should read. Click here for the full story, written by Susan K. Livio.

Here is the headline:

"Since Gov. Jon Corzine signed the landmark postpartum depression law 20 months ago, [New Jersey] has spent $9 million on the program: half on TV and radio ads and brochures encouraging women to ask for help, and half on training more than 6,000 medical professionals in how to identify the illness.

But health experts and women using the hotline say the law has fallen short: Women are seeking help, but when they do, state and medical professionals often are not prepared to assist them.

Many women found a state hotline staffed by people who were inexperienced at helping those in a mental health crisis. Obstetricians, gynecologists and other doctors often are afraid to get involved, they say, because of their lack of psychiatric knowledge. And there is a shortage of mental health professionals skilled in treating the illness."

"The people who did speak up were greatly disappointed," said Joyce Venis, a Princeton psychiatric nurse who treats women with perinatal mood disorders and served on the state advisory group that assembled the public awareness campaign. "How could this happen? I believed this was going to be a good program…"

The story goes on to share stories of women who definitely did not receive the type of treatment we would want them to receive when suffering from a postpartum mood disorder. How could this happen?

It happened because what New Jersey is trying to do, and what all other states should do, is hard. VERY HARD. We can make laws and create nice advertisements and set up toll-free hotlines and have the best intentions, but what needs to change is a lot of processes and attitudes that have been around for a very long time. As I wrote in a post a little over a week ago, if we don’t make it clear exactly who is responsible for caring for the mental health of postpartum women, and if we don’t have buy-in from those people, and if we don’t have well-trained mental health professionals available everywhere, then we don’t have what we need.

These projects are the kinds of projects that take years to implement fully and properly. Sure, it would seem from the article that there are certain things New Jersey could have done better from the outset, like staffing the hotline with better trained workers. But at the same time the state can’t help the fact that there aren’t enough psychiatric professionals who really know how to treat women with PPD and related disorders. (In the article, one woman was told by her doctor that PPD is a made-up illness for goodness sakes!) Additionally, as some of you have experienced, there are doctors who will say they know how to treat women with PPD and then it turns out they really have no experience in this area and we have to start over and find someone else, having wasted weeks or months continuing to suffer. It’s not New Jersey’s fault if doctors like that self-select to be on the referral list — the state has no way of really knowing who is good at this and who isn’t.

I just want to thank New Jersey for trying. I hope they take a look at where they’ve gone wrong and try to do better. More importantly, I hope that the various constituencies who are key to the success of the process — OB/GYNs, hospitals, child welfare workers, psychiatric professionals, med schools and law enforcement — do the same. I just really believe that New Jersey will get there. It may be painful for those of us who don’t get the best care when it’s our turn, but down the road hundreds of thousands of women will benefit. I look forward to that day.