This Nurse Practitioner Saw a Need to Support Moms' Mental Health — and Created a Clinic and a Hotline

Christena Raines tells PEOPLE about opening the first in-patient Perinatal Mental Health unit in the country and serving as the Board Chair of Postpartum Support International

Mother and baby at home

For Christena Raines, normalizing mental wellness has been a life-long mission. The women's health nurse practitioner is also board certified in Psychiatric-Mental Health and is outspoken about the importance of prioritizing mental health.

"Mental wellness affects everything we do and determines how well we do anything," Raines tells PEOPLE. "I think one of the gifts of COVID is that it has exposed the need for good mental hygiene and the ability of all of us to understand what self care means to us and how we can keep the mind-body connection in alignment."

That's especially crucial for postpartum women, Raines says; she has worked as a nurse for over four decades, but was especially drawn to women's health and the perinatal period after experiences in her own life — which she believes "adds authenticity to my work."

Christena Raines
Christena Raines, MSN, RN, APRN-BC, PMH-C. Carole Swanson photography

"Working in high risk labor and deliveries formed my passion for women in the reproductive phase of their life," she recalls. "I moved from being a staff nurse to obtaining my Women's Health Nurse Practitioner degree and began working with women during pregnancy and postpartum."

Treating countless patients with depression and anxiety led her to return to school to obtain a post-graduate degree as a Psychiatric-Mental Health Nurse Practitioner.

"My patients would come with somatic issues like headaches, stomach aches, and what I found was that what they really needed was someone to listen to them and validate their feelings," she explains, which eventually led her to coin the phrase 'Perinatal Psychiatric Nurse Practitioner' with her colleague Dr. Samantha Meltzer-Brody at the University of North Carolina at Chapel Hill, where they also founded the Perinatal Mood Disorder program.

Raines went on to help open the first in-patient Perinatal Mental Health unit in the country at UNC in 2011, after being unsatisfied with the treatment women received in the psychiatric unit — then the only option available to them.

"These women needed a calm environment to process their feelings and to understand what was happening to them," she explains. "They needed specialized programming to understand their illness and a staff who could help them adjust to motherhood and bond with their baby."

The unit was modeled after the Mother-Baby units in Europe, but without having universal health care in the United States, Raines knew having a separate nursing unit for babies to stay with their moms for 24 hours would be an uphill battle.

"We worked around this by allowing open visiting hours with another adult to support and care for the infant, while providing protected sleep for mom as well as groups and education on their illness," she says. "It has worked very well and we were very fortunate that the stars and moon aligned for us to have the ability to open this unique unit in the US."

Her extensive work led Raines to volunteer with Postpartum Support International, an organization formed in 1987 to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum. She was been part of the group for over a decade and now serves as a Board Chair.

"Giving back to the community was one of the reasons I joined PSI. Three years ago I spearheaded an initiative to establish state chapters so families have a way to give back to their communities," she says. "One of the largest issues in perinatal mood disorders is a lack of trained providers to offer evidence-based treatment. We offer support services through volunteer support coordinators and have over 500 volunteers in every state over 40 international countries."

Postpartum Support International have recently increased their reach by gaining a funding contract from the federal government to create a maternal mental health hotline to help families get the resources and support they need. (Until it launches, you can call the PSI Helpline to get support from volunteers at 1-800-944-4773, or you can text "HELP" to 800-944-4773 in English or 971-203-7773 in Spanish.)

"Having a hotline for families to reach out to 24 hours a day, 7 days a week, 365 days a year is crucial to the care of these families," Raines says.

But before they could get the funding approval, they had to educate the government on how critical maternal mental health actually is, and concedes it can be "a slow process." But she was able to make an impact, and several bills in the Build Back Better act purport to address some of the immediate issues.

"Mental health concerns affect us all," she says. "And when it disrupts the ability for mothers, fathers, and families to create a healthy environment for newborns, it becomes a crisis for the family ... Increased funding for research and treatment options will go a long way in helping all families receive the care they deserve and so desperately need."

Raines has seen the stigma surrounding maternal mental health reduce with the help of increased education and conversations across all diverse groups, as well as an increase in acceptance from the hard work she has done.

"I have seen my clients get better and have a wonderful and happy pregnancy and postpartum with subsequent pregnancies," she says. "I have seen organizations like the American College of Obstetricians and Gynecology, American Academy of Pediatrics and midwifery organizations accept and embrace the need for education and treatment. I am hopeful and grateful for the work we are all doing and I expect big things to come in working with our colleagues in both the state and national legislation."

If you or someone you know needs mental health help, text "STRENGTH" to the Crisis Text Line at 741-741 to be connected to a certified crisis counselor.

Raines retired from UNC in early 2020 and has since started a consulting company, though she still works with perinatal patients in a small private practice, which is her passion. She resides outside of Chapel Hill with her wife and has five adult children, for whom she's seen "mom's psycho mumbo jumbo" foster an environment where they can talk about their feelings and prioritize compassion for others, and teach those lessons to her seven grandchildren.

The younger generation's increased awareness, as well as the normalization of talking openly about mental wellness, gives Raines hope for the future.

"It is an exciting time and we are posed to usher in big changes," she says. "It takes a village, there is strength in numbers, and together, we can keep the focus on maternal mental health and bring help to all families who are suffering during a time that needs to be happy and supported."

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