Thank you.

I am an associate professor at McGill University, in the department of education and counselling psychology, as well as an associate member of the departments of pediatrics and psychiatry. I am also a scientist at the Research Institute of the McGill University Health Centre. As such, I bring together the perinatal mental health expertise and early childhood development. This is what I'm going to advocate for today.

I will add on to what my colleague mentioned.

The perinatal period is defined as the gestational period of pregnancy until 12 months postpartum. We know that perinatal mental health disorders, such as depression and anxiety, are among the most common complications of childbirth, affecting as much as 20% of pregnant and postpartum individuals. The rates of postpartum depression have doubled since the COVID-19 pandemic. This is from a source provided by Inspiring Healthy Futures, with the contribution of Health Canada and the Public Health Agency of Canada. The source estimates that the incidence of mental health issues among both women and men have increased by more than 10%.

These statistics are reported to affect an even greater number of women in marginalized and under-represented populations, such as IBPOC women, who are disproportionately affected by mental health issues and are most often missed in these reported studies. We're not specifically targeting these populations and, as such, it questions the generalizability of the findings that we often report.

More than 350,000 individuals become pregnant in Canada every year, which suggests that up to 105,000 Canadians may experience perinatal anxiety and mood disorders, making them the most common pregnancy complication. Pregnancy complications don't just have implications during pregnancy, such as gestational hypertension, pre-eclampsia or gestational diabetes, which have received recognition for their predictive roles in the incidence of more chronic disease later on in a woman's life. This is not the case, however, for mental health during that same critical period of women's health.

It was mentioned that maternal suicide is a leading cause of maternal death in high-income countries. Maternal depression and anxiety are associated with an increased risk of preterm birth, low birth weight and child social, emotional and behavioural difficulties. This is where my child expertise comes in. It's also known to basically continue to have a lifelong effect into adolescence and be associated with mental health issues in teenagers into adulthood.

Some causal analyses have been conducted in the United States, the United Kingdom and Australia. These are countries that are very comparable to the one that we are living in, Canada. They highlight the significant economic impact of untreated perinatal mood and anxiety disorders in Canada. Thus, many experts working in the area, such as us here today, do question the lack of early detection and appropriate treatment of maternal depression and anxiety, as well as its consideration as a public health priority.

Unlike other gestational conditions affecting the pregnant person, mental health issues remain the most underdiagnosed. To just give a little representation or equivalent, according to Diabetes Canada, gestational diabetes affects one in 10 women—we said that mental health issues affect about 20% of women. One in every 632 births would result in a baby with potential complications such as Down's syndrome. This, again, is according to Health Canada data. This data alone has sufficed over the years to understand the need to conduct and maintain systematic nuchal translucency and gestational diabetes screenings as part of routine prenatal care. Despite what we know of the incidence of mental health issues and the fact that they affect both the woman's health and the child in terms of intergenerational transmission, we do not have the same type of screening when it comes to mental health issues during pregnancy. It's not part of our prenatal care, unlike some of the countries that I mentioned before, which are developed countries like ours.

That being said, given the high prevalence and adverse consequences of perinatal mood and anxiety disorders, several countries have now recommended—as has been mentioned before and will be mentioned again—the need for routine screening for prenatal anxiety, depression and other mental health issues during the course of pregnancy. The failure to identify these risk factors of adverse perinatal mental health outcomes can have negative consequences for the mother, as I mentioned, but also for the child.

Using an existent evidence-based model stemming from the London School of Economics, we've been able to conduct this same type of economic impact calculator with the Montreal antenatal well-being study that I represent. The economic impact tool was necessary to determine the economic cost of perinatal health mood disorders and also enable us to make these estimations throughout every province. We are now upscaling this tool to include cost-effectiveness of interventions and referral interventions in the Canadian context.

The first phase of our economic impact calculator has produced an estimate that a lack of routine screening in Canada would lead to a cost of about $6.7 billion per year in Canada. The cost of perinatal mental health illnesses in Canada is associated with about $46,000 per birth for deliveries, and about 70% of these are accountable to the child. The child would basically go on to develop such adverse effects and outcomes as poor cognitive functioning, which is also impacting their future development.

The evidence speaks for itself. The benefit to the mother or pregnant person can be achieved via preventative care during the prenatal phase. Not only can this present as a benefit to the woman during pregnancy; it could also play a critical role in early detection and prevention of other postpartum diseases, as I've mentioned, such as breast cancer, cervical cancer, cardiovascular disease, diabetes and osteoporosis.

Using a precision health framework—