Pregnancy and motherhood should be a time of joy, yet for many women struggling with addictive disorders like substance use disorders (SUDs), it is fraught with stigma and shame. The fear of judgment from healthcare professionals and society often prevents pregnant and postpartum women from seeking the help they desperately need, putting both their health and their babies at risk. The UAMS Women’s Mental Health Program provides a safe, stigma-free environment where these women can access the critical treatment and support necessary for a healthier future for themselves and their children.
IN THIS BLOG
- What is the UAMS Women’s Mental Health Program?
The UAMS Women’s Mental Health Program treats mental illnesses in women, particularly pregnant and postpartum women or women who are trying to conceive. The program offers critical treatment and support necessary for a healthier future.
- Who can participate in the program?
To participate in the program, individuals must be pregnant, six months to a year postpartum, or trying to get pregnant. The clinic serves women in Arkansas and neighboring states, including Missouri and Oklahoma.
- What types of treatments does the program offer for substance use disorders?
The Women’s Mental Health Program offers a range of treatment options for SUDs, including inpatient care, long-term inpatient units, and intensive or standard outpatient treatment programs. Additionally, the program provides medication assistance and addresses co-occurring mental health issues, such as depression and anxiety.
- How does the clinic screen for SUDs?
The clinic follows American College of Obstetricians and Gynecologists by using verbal screening methods, such as the Five Ps test, which assesses a patient’s drug and alcohol use in various contexts.
- Why is tracking data on SUDs important, and what challenges does the program face?
Tracking SUD data is essential for research and prevention efforts, helping identify areas with high prescription rates and focus resources accordingly. However, challenges arise in rural areas of Arkansas due to transportation barriers, making it difficult to access treatment and obtain accurate data on every woman with an SUD in the state.
Dr. Shona Ray-Griffith is the program director of the Addiction Medicine Fellowship Program at UAMS, an associate professor in the Department of Psychiatry, and the outpatient director for the Women's Mental Health Program. She recently went on AFMC TV to discuss the program and its impact on women’s health across the state.
The Women’s Mental Health Program treats mental illnesses in women, particularly pregnant and postpartum women or women who are trying to conceive. “We treat mental illnesses of all types, including substance use disorders,” Dr. Ray says.
Located at the main UAMS campus in Little Rock, the program has two clinics: one in the Psychiatric Research Institute adjacent to the UAMS hospital and one in the UAMS Women’s Center in Midtown. In July 2025, the program will expand to Northwest Arkansas, where Dr. Erin Jefferson, UAMS’s first women's mental health psychiatrist, will see patients in Fayetteville.
Participation Criteria
“To participate in the program, you must be pregnant, six months to a year postpartum, or trying to get pregnant,” Dr. Ray explains. The clinic sees patients from all throughout the state and even from neighboring states like Missouri and Oklahoma. Dr. Ray says UAMS takes all insurance types.
The clinic offers mental health treatment for anxiety, depression, typical mood disorders, and more serious mental illnesses, such as bipolar disorder and schizophrenia. “We also have a specialized program for women with co-occurring disorders, such as SUDs,” Dr. Ray says.
The majority of women who engage with the program are seeking treatment for opioid use disorder, but some patients may also need treatment for methamphetamine, cannabis, and alcohol use, which has increased nationally since the pandemic.
Personalized Treatment Plans
Each patient needs an individualized treatment approach, and the clinic offers various treatment programs for patients with SUDs. “Some of our patients require inpatient care, including medical stabilization,” Dr. Ray says. “After that, they can go to a long-term inpatient unit for about 30 days or an intensive or standard outpatient treatment program.” Some patients may not need any formal medical treatment at all and may simply engage in a 12-step program instead.
The Women’s Mental Health Program also offers medication assistance, meaning that women with SUDs are prescribed medication that can help during pregnancy. “More importantly, we find that women with SUDs often have co-occurring mental health issues, such as depression, anxiety, and trauma disorders,” Dr. Ray says. “We offer medication management for that if it’s warranted.”
Screening Procedures and Tracking Data
The Women’s Mental Health Program follows the American College of Obstetric and Gynecology’s recommendation to use verbal screening. This requires asking the patient about their drug and alcohol use. Dr. Ray’s clinic uses the Five Ps screening test, which asks whether the patient has used drugs or alcohol in specific situations:
- Present: Within the past month of your pregnancy, did you drink beer, wine, liquor, or use other drugs?
- Past: Before you became pregnant, did you have any problems with alcohol or drug use?
- Peers: Do your peers or friends have any problems with alcohol or drug use?
- Parents: Do your parents have any problems with alcohol or drug use?
- Partner: Does your partner have any problems with alcohol or drug use?
Dr. Ray states that, although the rate has improved since the beginning of the national opioid epidemic, Arkansas’s opioid prescribing rate has remained above the national average, ranking within the top three highest prescribing states nationally. Tracking data on SUDs helps determine where prescribing rates are the highest, which helps focus efforts in those areas to reduce the prescription rate and help prevent SUDs.
While data metrics for SUDs are important for research and prevention efforts, data in Arkansas does not reveal the true numbers statewide. Although Dr. Ray’s clinic tracks SUD data, it is simply impossible to track data for every woman with SUDs in the state. “We are a very rural state, and patients have trouble accessing treatment due to significant barriers like transportation,” she says.
One of the most effective ways to track SUDs among pregnant women is to track the number of infants born with neonatal opioid withdrawal syndrome. However, even this does not paint the whole picture, as not every infant whose mother struggles with SUDs will develop neonatal opioid withdrawal syndrome.
Opioid Use Laws and Stigma
Some women who suffer from SUDs may be hesitant to seek treatment or tell their doctor they are using. Garrett’s Law states that if a woman or baby has an illicit drug in their system during delivery, DHS must be contacted to perform an investigation. “Women are aware of this, and that’s why they’re hesitant to disclose their substance use or even seek treatment,” Dr. Ray says. “I have had numerous patients come to me for treatment before they begin obstetrical care.”
Some of the hesitance or reluctance to get help also comes from stigma, which can exist both in the provider and public community. “Some of these patients are judged so negatively,” Dr. Ray says. “People will ask how someone can continue to use during pregnancy. There’s also a lot of guilt.”
Additionally, pregnant women must interact with multiple specialists throughout the process, including OBs, nurses, social workers, pediatricians, and other medical professionals. Stigma may occur during interactions with any of these people.
Dr. Ray adds, “These women who seek and receive treatment don’t want to harm their babies. They want to be good mothers. They want to do the right thing, and they feel terrible about not being able to stop using.”
Resources and Support
Providers cannot start a conversation with a patient about SUDs unless they ask and screen. “Patients may not open up to you initially,” Dr. Ray says. “Eventually, throughout the pregnancy, they may start to open up if they feel they can trust you and feel nonjudged and non-stigmatized.”
There are stigma-free environments that can help. Dr. Ray encourages women who are suffering from SUDs, particularly pregnant women, to reach out to the Women’s Mental Health Program at UAMS or one of the other facilities throughout the state:
- Lake Point Recovery and Wellness in Russellville
- Harbor House in Hot Springs
- Gateway Recovery Center in Fort Smith
- Arkansas CARES in Little Rock
There are also inpatient substance abuse rehabs for women, specifically women with children or women who are expecting. Each of these facilities provides multiple services for women, including housing for the woman and her child. “These are all excellent resources, and they are more than willing to help and will find a bed if you are a woman who needs assistance.”
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