June 2026 FCC Community Exchange

Thank you to the 165+ members who joined us for this month’s FCC Community Exchange session! We’re incredibly grateful to Christine Neugebauer, PhD, LPC-S, MT-BC and Kara Pepper, M.MFT, LMFT who shared their unit’s success implementing mental health support for NICU families.

Resources Shared:

• The NICU Dad
  ^Awareness, resources, and community for dads facing a NICU journey

• Nurtureum Framework
  ^Turns early biological, psychosocial, and family signals into a practical recovery-risk view for infants, caregivers, and clinical teams.

• Nurturing Mamas Network
  ^Advancing maternal mental health through clinical excellence, advanced education, and multidisciplinary collaboration

• Postpartum Support International (PSI)
  ^Resources and support for both families and clinician 

Q&A Highlights:

Q: How are you documenting for caregivers who don’t have their own chart at your institution?

A: We chart mothers’ Edinburgh (EDPS) screenings in the baby’s chart, however we’ve gotten permission to block every screen from being released in MyChart, which is something we established and got approved before we began screening. If someone requested medical records for the baby, mom’s Edinburgh screens are there which is standard practice in our region’s pediatric spaces. Our charting meets documentation requirements required by licensing but is intentionally vague and done in the same fashion one would chart about a domestic abuse victim [in order to protect parents’ privacy and custody of their infant].

Q: How to you approach concerns that arise from mental health screenings? (suicidal ideation, etc.)

A: We have a policy in place that was created in collaboration with the head social worker who is an LCSW. She is the person facilitating EDPS screenings and is trained in immediate crisis work. We have a great working relationship with our local mental health authority where we are able to get families immediate crisis help if needed. Many times, safety planning is sufficient for NICU family needs.

Q: How does your role as a Lisenced Marriage and Family Therapist (LMFT) collaborate with psychologists on the unit?

A: We do not have psychologists on our unit, however in the state of Texas LMFT are allowed to do what psychologists can so I (Kara) can function in that role and refer to outpatient services if needed. If I (Kara) did collaborate with a psychologist in the unit, it would allow for bandwidth to do couples and family work. The unit is fortunate to have psychiatry consult through the OB unit.

Q: Can you share more about the role of your unit’s social worker from a clinical standpoint, how you distinguish your roles, and how you collaborate without duplicating your efforts.

A: I (Kara) do all the mental health clinical work, except for safety screenings which are handled by our social worker. Our main overlap happens with care conferences. We meet beforehand to establish who will be the lead and who will pace that lead. If the focus is medical equipment needs, she (social worker) will take the lead. If the focus is end of life care, I (Kara) will take the lead. She (social work) is assessing for medical and practical needs, while I assess family relationships and mental health. We are in constant, daily communication.

Q: Are fathers and non-birthing parents in your unit screened?

A: Right now, they are only screened on a case-by-case basis.

Q: Are there times when these services aren’t offered? (i.e., evenings, nights, weekends)

A: We only screen when we are available, which is between 8am-3pm, Monday through Friday. This gives us two additional hours in the afternoons to address any immediate crisis needs. If a social worker is there on the weekends, they will address any screenings that need to happen. This is why staff training is so important, so support can be offered even when LMFTs and LMSWs aren’t available.

Q: Can you talk about the didactic work between the mother/baby dyad?

A: That’s where I would utilize Music Therapy and Child Life Services, however if those services are not available, I will support mom in exposure therapy to her infant.

Q: If you identify a caregiver as needing screenings and support, are they able to deny services?

A: Absolutely, families in our unit have autonomy and we can’t violate that.

Q: When are screenings happening?

A: Upon admission and every two weeks.

Q: How are screenings done? Verbally? Electronically? Pencil & paper?

A: We use pencil and paper, however if necessary, we will do a verbal screening over the phone.

Q: Have you had experience supporting families across multiple units, such as across the NICU and PICU?

A: Unfortunately, we don’t have the bandwidth to regularly work in the PICU. At one time we hired a pediatric mental health provider for the PICU and we had some success with warm handoffs, but for now this is a gap.

Q: Do you bill for your mental health services in a particular way and how do you transfer families to outpatient mental health services?

A: We do not bill, Kara is part of the care team which helps free up her approach to work with families. If you need to bill, AAMFT is a great resource for billing in these contexts. We transfer families to trusted mental health providers in the community and do our best to honor their preferences (male vs. female provider, insurance vs. pay out of pocket) by creating personalized referral lists.

Q: What does your patient census look like?

A: Kara covers around 100 patients at a time, roughly 30-40 in the NICU and others in Labor & Delivery.

Tips from Christine & Kara:

• Postpartum Support International (linked above) is a great place to start for mental health information

• Ask local mental health practitioners who specialize in maternal mental health to come in to train your staff

• Nurturing Mamas Network (linked above) is a great resource for staff mental health training

• It’s important to support your staff in self-care so they can adequately provide support to others without burning out