Missouri Mental Health Screenings Remained Unmandated

State officials have not required prenatal mental health checks as maternal mortality rates remain a critical concern.

Updated on Sept. 28, 2026 in Mental Health

Isometric editorial illustration of a clinical reflex hammer and stethoscope on a clean surface, representing gaps in state mental health policy. — Missouri continues to lack a mandate for prenatal mental health screenings, despite findings that mental health conditions contribute to nearly a quarter of maternal deaths in the state. AI Illustration. Upload story photo >

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Should states mandate mental health screenings for all pregnant and postpartum patients?

Missouri currently lacks a mandate requiring mental health screenings for pregnant or postpartum patients despite data linking mental health conditions to nearly a quarter of recent maternal deaths. This gap persists even as health experts highlight that the vast majority of these pregnancy-related deaths are considered preventable.

Why it matters

Mental health conditions have emerged as a primary driver of pregnancy-related fatalities, yet patients often avoid disclosing struggles due to fears of child protective services involvement. Addressing these barriers is vital given that nearly every county in Missouri is officially designated as a mental health professional shortage area.

The mortality rate for women on Medicaid is 2.9 times higher than those with private insurance, while Black women face a 2.5 times higher mortality rate than white women. Furthermore, rural residents are 21% more likely to experience perinatal depression than those in urban areas.

The players

Policy Center for Maternal Mental Health

This organization tracks and grades state policies regarding the provision and accessibility of maternal mental health care.

Maternal Health Access Project

This initiative provides a framework for clinical providers to consult with psychiatrists regarding patient treatment plans.

The details

In a review of 38 maternal deaths, investigators found that providers failed to complete necessary mental health screenings for patients. While the Maternal Health Access Project now allows providers to consult with psychiatrists on treatment, the state maintains only a C grade for maternal mental health initiatives from the Policy Center for Maternal Mental Health.

Between 2017 and 2019, 17 women died from mental health and substance issues.
Mental health conditions contributed to 25% of maternal deaths from 2019 to 2023.
Rural women were found to have a higher depression risk in a 2020 study.
The Policy Center for Maternal Mental Health awarded Missouri a D-minus in 2023.
Missouri improved its maternal mental health grade to a C in 2026.

Health Landscape

The report serves as a diagnostic benchmark for the state, identifying systemic failures in prenatal care that contribute to high maternal mortality rates. These findings underscore a broader challenge in medical science where identifying preventable causes has not yet translated into universal clinical mandates.

Pregnant patients in Missouri may need to proactively request mental health screenings from their providers, as these checks are not currently required by state law. Families should be aware that local professional shortages, particularly in rural areas, can significantly impact access to timely psychiatric consultation.

The takeaway

Patients who feel comfortable initiating conversations about their mental well-being may gain access to better support systems through current voluntary programs. It is crucial for families to advocate for comprehensive prenatal care that includes mental health evaluations regardless of existing state mandates.