Lifeline for Families
The Lifeline for Families Center at UMass Chan Medical School develops and scales interventions that support parents, children, and their relationship to each other. They lead national projects that focus on increasing access to parent and child mental healthcare with a trauma-responsive and relational health lens. Lifeline for Families was developed through multidisciplinary collaboration between psychiatry, obstetrics/gynecology, psychology/behavioral health, and pediatrics to break down silos and unite our fields.
Our aim is to mitigate morbidity and mortality caused by negative mental health outcomes and to promote healing among families and communities that have been marginalized and stigmatized. Despite growing attention to our nation’s mental health crisis, lack of access persists, and maternal and child deaths due to mental health disorders continue to rise. In response, we have increased capacity in traditional and non-traditional settings to promote the mental health of families. In close collaboration with community partners, we develop, implement, and test scalable and sustainable interventions that increase equitable access to and engagement with evidence-based mental health care for families. A critical feature of our work is investing in and training the next generation of clinicians, researchers, educators, and policy makers through mentorship and sponsorship. Lifeline for Families is led by Executive Director Dr. Nancy Byatt and Associate Director Dr. Jessica Griffin.
Housed within the Lifeline for Families Center is the Lifeline for Moms Program, which is led by Executive Director Dr. Nancy Byatt and Director of Obstetrics Dr. Tiffany A. Moore Simas. The Lifeline for Moms Program promotes perinatal mental health by helping develop, implement, innovate, evaluate, and sustain approaches for addressing perinatal mental health and substance use disorders. Our perinatal psychiatry trainings, services, and resources aim to increase access to and engagement in mental health care.
Core Services:
Capacity building: to promote perinatal health care by building healthcare professionals’ capacity to provide perinatal mental health support, services, and interventions. Our evidence-based, customizable products and resources are free and help clinicians prevent, identify, and treat perinatal mental health conditions.
Consultation: to offer consulting services to support perinatal care professionals as they develop their own Perinatal Psychiatry Access Program or integrate care for perinatal mental health and substance use disorders into their practice workflow.
Research: to develop and test interventions and resources designed to improve existing care models and close remaining gaps in care. Many of these perinatal mental health trainings, toolkits, and digital apps have been disseminated and implemented across the U.S. and the world.
For more information, see their website: https://www.umassmed.edu/lifeline4moms/
Meet the Researchers:
Nancy Byatt, DO, MS, MBA, DFAPA, FACLP
Professor with Tenure of Psychiatry, Executive Director
Clevanne Julce, PhD, MPH
Assistant Professor of Psychiatry
Sarah Palmer, MD
Assistant Professor of Psychiatry
Chris Sheldrick, PhD
Professor of Psychiatry
Martha Zimmermann, PhD
Assistant Professor of Psychiatry
Research:
The Lifeline for Moms Network of Perinatal Psychiatry Access Programs - Year 7
Title: The Lifeline for Moms Network of Perinatal Psychiatry Access Programs – Year 7
PI: Nancy Byatt, DO, MS, MBA, DFAPA, FACLP
Funding: Perigee Fund
Total Direct + Indirect Costs: $200,000
Time Frame: 10/01/2025–09/30/2026
Description:
The goals are to 1) Continue to strengthen work from the past four years with a commitment to equity through 1) facilitating peer learning and sharing of resources among aspiring, emerging, and established Perinatal Psychiatry Access Programs, and relevant partners and collaborators, across the U.S.; 2) harmonizing data collection across programs; 3) facilitating quality improvement and program evaluation within and across programs; and 4) engaging in bidirectional feedback with member programs and community partners.
Reaching Calm: A Digital Intervention to Prevent Perinatal Anxiety Disorders
Title: Reaching Calm: A Digital Intervention to Prevent Perinatal Anxiety Disorders
PI: Martha Zimmermann
Funding: National Institute of Mental Health Mentored Patient-Oriented Research Career Development Award (K23)
Total Direct + Indirect Costs: $646,910
Time Frame: 09/15/2025-08/31/2029
Description:
Up to 1 in 5 perinatal individuals experience anxiety disorders, which can have lasting effects on parents and children. The project focuses on prevention rather than treatment, using Anxiety Sensitivity Interventions (ASI). Anxiety Sensitivity Interventions (<6 sessions) are cognitive-behavioral strategies that target malleable risk factors for anxiety rather than treating symptoms. While Anxiety Sensitivity Interventions have demonstrated effectiveness in the general population, they have not been tested for perinatal individuals, nor have they been scaled to reach a large population.
Dr. Zimmermann’s team has developed Reaching Calm, a digital, multicomponent intervention that includes:
- A digital ASI with SMS text messages and web-based tools
- Training for obstetric providers
- An implementation protocol for integrating prevention into obstetric care
Through a pilot cluster randomized controlled trial (RCT), this project will evaluate feasibility (Aim 1), acceptability and preliminary effectiveness (Aim 2), and user engagement strategies (Aim 3). Using a community-engaged, user-centered design and implementation science framework, this project will lay the groundwork for an R01 trial testing the intervention’s effectiveness and sustainability in real-world obstetric settings.
Initiative A Feasibility Study of Candlelit Care: An AI-Assisted Culturally Congruent Perinatal Mental Wellness App for Underserved Postpartum Women
Title: Initiative A Feasibility Study of Candlelit Care: An AI-Assisted Culturally Congruent Perinatal Mental Wellness App for Underserved Postpartum Women
PI: Martha Zimmermann, PhD
Funder: Massachusetts eHealth Institute (MeHI) Advancing Health Equity in Massachusetts (AHEM)
Total Direct + Indirect Costs: $50,000
Time Frame: 07/01/2025-12-31/2025
Description:
The study team will work alongside a community partner to develop its mental health screening and treatment platform that improves early intervention for perinatal mood and anxiety disorders, with a focus on the maternal health of underserved women. The goal of the study is to test the feasibility of the mobile app with 30 UMass Memorial Health patients who are at risk of developing preventable perinatal mood and anxiety disorders.
Beta-Testing Reaching Calm: Exploring Digital Approaches to Address Suicide Risk in Obstetric Settings
Title: Beta-Testing Reaching Calm: Exploring Digital Approaches to Address Suicide Risk in Obstetric Settings
PI: Martha Zimmermann, PhD
Funder: Center for Accelerating Practices to End Suicide (CAPES) Scholar (R03)
Total Direct + Indirect Costs: $47,855
Time Frame: 01/01/2025–12/31/2025
Description:
This study aims to integrate suicide risk assessment intervention into the Reaching Calm intervention by adapting Reaching Calm to include the Computerized Adaptive Test Suicide Scale (CAT-SS) and beta-testing Reaching Calm at one obstetric clinic.
A Type I Hybrid Effectiveness-Implementation Trial of "Mothering from the Inside Out" (MIO)
Title: A Type I Hybrid Effectiveness-Implementation Trial of "Mothering from the Inside Out" (MIO)
Site PI: Nancy Byatt, DO, MS, MBA, DFAPA, FACLP
Funder: National Institutes of Health/National Institute on Drug Abuse
Total Direct + Indirect Costs: $3,340,591 ($114,500 direct; $77,275 indirect)
Time Frame: 09/30/2024–07/31/2029
Description:
Mothers with substance use disorders face unprecedented stress in their roles as parents working to care for their children while maintaining healthy recovery. Mothering from the Inside Out (MIO) is the first attachment-based parenting intervention designed specifically for mothers in recovery from substance use disorders that has been shown to have bigenerational benefit in multiple randomized controlled trials. This project will: (a) test the effectiveness of MIO among women in outpatient addiction treatment under ‘real-world’ conditions, (b) further elucidate the MIO mechanism of change associated with improvements in caregiver behavior and maternal mental health outcomes, and (c) assess key implementation constructs to support optimal uptake and treatment in future dissemination studies; closing an important science-to-service gap for an underserved population in an effort to support maternal and child health simultaneously.
Early Intervention: Understanding Attachment and Attrition
Title: Early Intervention: Understanding Attachment and Attrition
PI: Sarah Palmer, MD
Funder: American Academy of Child and Adolescent Psychiatry’s Pilot Research Award for Early Career Faculty and Child and Adolescent Psychiatry Fellows Award
Total Direct + Indirect Costs: $15,000
Time Frame: 08/01/2024–10/31/2026
Description:
This funding supports an exploratory qualitative study to better understand the barriers and facilitators to family engagement with Early Intervention, a federally funded developmental service provided to children aged 0-3 years old who either are diagnosed with developmental delay or are at risk of having developmental delay. We are working to understand how the relationships or “attachment” between caregivers, service providers, and children can support engagement in services as we work to develop an intervention that will increase service utilization and access to developmental supports for children and families.
Increasing Research Partnership with Engagement Mapping: A Pilot Study to Advance Engagement Science
Title: Increasing Research Partnership with Engagement Mapping: A Pilot Study to Advance Engagement Science
Site PI: Radley (Chris) Sheldrick, PhD|
Funding: Patient Centered Outcomes Research Institute (PCORI)
Total Direct + Indirect Costs: $2,090,183
Time Frame: 05/01/2024–4/30/2027
Description:
The goal of this study is to advance the meaningful engagement of populations underrepresented in PCOR/CER mental health research studies. The researchers will (1) conduct a scoping review of engagement methods for individuals underrepresented in research partnerships, (2) create a consensus-based guide to engagement methods through a modified Delphi Panel of external PCOR/CER mental health equity and engagement experts, and (3) conduct a pilot study to refine, implement and test the feasibility of Engagement Mapping with four Advisory Councils.
Pathways to Perinatal Mental Health Equity (Pathways)
Title: Pathways to Perinatal Mental Health Equity (Pathways)
PIs: Nancy Byatt, DO, MS, MBA, DFAPA, FACLP & Wendy Davis, PhD
Funding: Patient-Centered Outcomes Research Institute (PCORI)
Total Direct + Indirect Costs: $21 million
Time Frame: 04/01/2024–03/31/2031
Description:
The goal of Pathways is to conduct a Hybrid Type I Comparative Effectiveness Study to compare a healthcare system-only approach to addressing perinatal mood and anxiety disorders in obstetric settings, the PRogram In Support of Moms (PRISM), to a Healthcare-Community Partnership approval. This study will examine what happens when healthcare- and community-based teams partner to deliver care for perinatal mood and anxiety disorders. The research has three aims, (1) ensure that researchers engage with obstetric practices that are in greatest need, (2) test the effectiveness of the study’s partnership, and (3) prepare to spread what the study team learns to other obstetric practices. The researcher-community partnership is led by Postpartum Support International (PSI), a community-based organization promoting mental health awareness, support, and treatment for pregnant and postpartum individuals worldwide, and UMass Chan Medical School. The study is designed to answer the question, “Should we put our resources into a healthcare system approach or a healthcare-community partnership approach to mental health care?” The results of this study will help states and healthcare systems decide how to develop pathways for increasing access to mental health care for pregnant and postpartum women.
Whole Family Wellness: Supporting Parents across Systems of Care
Title: Whole Family Wellness: Supporting Parents across Systems of Care
PIs: Nancy Byatt, DO, MS, MBA, DFAPA, FACLP & Elizabeth Peacock-Chambers, MD
Funding: Apricus Principle
Total Direct + Indirect Costs: $300,000
Time Frame: 01/10/2023-12/31/2025
Description:
Mothering from the Inside Out (MIO) is an attachment-based parenting intervention that improves parental mental health and parent-child relationships. It centers parent wellness and self-regulation as the foundation for a strong parent-child relationship, with a particular focus on parents who have experienced trauma, adversity, or marginalization. This project has three phases covering three years: 1) elicit input from community partners to inform the adaptation of MIO for delivery by community-based professionals; 2) adapt MIO for delivery by community-based professionals; (3) beta test the new adapted model. In year 1 (Phase 1), we will convene a working group of 6–10 key partners to inform how to best adapt MIO for community-based delivery. We will conduct focus groups and individual interviews with other key partners. In year 2 (Phase 2), we will combine Year 1 input with our team’s expertise and adapt MIO in response to our learnings from the working groups and focus groups. In year 3 (Phase 3), we will pilot test the adapted MIO and iteratively refine our approach. At the end of year 3, we will have a new scalable approach for delivering MIO in community-based settings.
Community-based, Family-centered, Trauma-informed Approach to Timely Detection and Management of Early Postpartum Hypertension
Title: Community-based, Family-centered, Trauma-informed Approach to Timely Detection and Management of Early Postpartum Hypertension
PI: Nancy Byatt, DO, MS, MBA, DFAPA, FACLP
Funding: Patient-Centered Outcomes Research Institute (PCORI)/Yale
Total Direct + Indirect Costs: $811,772
Time Frame: 11/01/2022-10/31/2027
Description:
The goal of this project is to improve clinical outcomes, including mental health outcomes, among postpartum at-risk women experiencing health disparities by increasing awareness, detection, and timely care of postpartum hypertension, mental health, and cardiovascular complications. The project aims to improve mean postpartum systolic blood pressure at six weeks and reduce depression severity at three months postpartum.
Developing a Scalable Intervention to Prevent Perinatal Anxiety in Obstetric Settings
Title: Developing a Scalable Intervention to Prevent Perinatal Anxiety in Obstetric Settings
PI: Martha Zimmermann, PhD
Funding: Mentored Career Development (KL2) Award, KL2TR001454
Total Direct + Indirect Costs: $265,870
Time Frame: 11/01/2022-05/31/2025
Description:
This project focuses on developing and iteratively refining the Prevent Perinatal Anxiety intervention, a multicomponent digital health intervention to prevent perinatal anxiety disorders. Community engagement, user-centered design, and implementation approaches will be used to adapt an Anxiety Sensitivity Intervention for digital health and for integration into obstetric settings to maximize intervention reach.
Developing a Multicomponent Intervention to Deliver Preconception Mental Health Support in Primary Care
Title: Developing a Multicomponent Intervention to Deliver Preconception Mental Health Support in Primary Care (1K12TR005450-01)
PI: Clevanne Julce, PhD, MPH
Funder: National Institutes of Health/The UMass Center for Clinical and Translational Science
Total Funding (Direct + Indirect): $204,324
Project Dates: 08/10/2026 – 07/31/2028
Description: Mood and anxiety disorders affect one in five pregnant women and are a leading cause of maternal death. Most interventions for mood and anxiety disorders are initiated after conception, missing a critical window for prevention. Preconception care is the management of health, lifestyle, and social risk factors before pregnancy to optimize maternal and infant health. While preconception care represents a cost-effective and population-level strategy to reduce psychiatric risk, it is rarely implemented in clinical practice. To effectively address and manage mood and anxiety disorders before pregnancy, preconception interventions need to be integrated into the primary care setting where women are already being seen for routine medical care. However, multilevel barriers persist among primary care clinicians, including limited time, skills, and resources. Our prior research indicates that Community Health Workers (CHWs) could help overcome challenges in implementing preconception mental health care in primary care settings by addressing health and social barriers. We also learned that digital health tools are critically needed to implement preconception mental health care at scale. Digital tools can complement patient-CHW interactions by standardizing risk identification and effectively delivering tailored behavior change techniques.
In this K12, the team proposes to develop a multicomponent, CHW-facilitated digital intervention, called MindNest, to fill translational gaps in delivering preventative mental health support before pregnancy. By combining scalable digital health technology with the trusted, relationship-based expertise of CHWs, MindNest aims to improve engagement and delivery of preconception mental health care in primary care. MindNest will include: 1) CHW training to strengthen capacity for follow-up and clinical collaborations; 2) a digital tool for module-based screening, education, and behavior change monitoring; and 3) an implementation protocol for clinical workflow integration. Using user-centered design and implementation science methods, they will: 1) design a blueprint for MindNest by identifying user needs and exploring determinants influencing primary care delivery through qualitative focus groups with reproductive-aged women and CHWs (Aim 1), 2) develop and iteratively refine the MindNest prototype with guidance from an Advisory Council and Clinical Working Group (Aim 2); and 3) beta-test MindNest in a UMass Memorial Health-affiliated primary care clinic using mixed methods to examine appropriateness, acceptability, engagement, and usability (Aim 3). This K12 award will provide the training and formative data needed to pursue a K01 to pilot MindNest and examine its efficacy and feasibility in primary care settings.
