(5) The symptoms of postpartum psychosis in-
clude losing touch with reality, distorted thinking, 
delusions, auditory hallucinations, paranoia, hyper-
activity, and rapid speech or mania. 
(6) Each year over 400,000 women suffer from 
postpartum mood changes, with baby blues afflicting 
up to 80 percent of new mothers; postpartum mood 
and anxiety disorders impairing around 10–20 per-
cent of new mothers; and postpartum psychosis 
striking 1 in 1,000 new mothers. 
(7) The causes of postpartum depression are 
complex and unknown at this time; however, theories 
include a steep and rapid drop in hormone levels 
after childbirth; difficulty during labor or pregnancy; 
a premature birth; a miscarriage; feeling over-
whelmed, uncertain, frustrated or anxious about 
one’s new role as a mother; a lack of support from 
one’s spouse, friends or family; marital strife; stress-
ful events in life such as death of a loved one, finan-
cial problems, or physical or mental abuse; a family 
history of depression or mood disorders; a previous 
history of major depression or anxiety; or a prior 
postpartum depression. 
(8) Postpartum depression is a treatable dis-
order if promptly diagnosed by a trained provider
and attended to with a personalized regimen of care 
including social support, therapy, medication, and 
when necessary hospitalization. 
(9) All too often postpartum depression goes 
undiagnosed or untreated due to the social stigma 
surrounding depression and mental illness, the myth 
of motherhood, the new mother’s inability to self-di-
agnose her condition, the new mother’s shame or 
embarrassment over discussing her depression so 
near to the birth of her child, the lack of under-
standing in society and the medical community of 
the complexity of postpartum depression, and eco-
nomic pressures placed on hospitals and providers. 
(10) Untreated, postpartum depression can lead 
to further depression, substance abuse, loss of em-
ployment, divorce and further social alienation, self-
destructive behavior, or even suicide. 
(11) Untreated, postpartum depression impacts 
society through its affect on the infant’s physical 
and psychological development, child abuse, neglect 
or death of the infant or other siblings, and the dis-
ruption of the family.
TITLE 
I—RESEARCH 
ON 
POSTPARTUM 
DEPRESSION 
AND PSYCHOSIS 
SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVI-
TIES OF NATIONAL INSTITUTE OF MENTAL 
HEALTH. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of NIH and 
the Director of the National Institute of Mental Health 
(in this section referred to as the ‘‘Institute’’), shall ex-
pand and intensify research and related activities of the 
Institute with respect to postpartum depression and 
postpartum psychosis (in this section referred to as 
‘‘postpartum conditions’’). 
(b) COORDINATION WITH OTHER INSTITUTES.—The 
Director of the Institute shall coordinate the activities of 
the Director under subsection (a) with similar activities 
conducted by the other national research institutes and 
agencies of the National Institutes of Health to the extent 
that such Institutes and agencies have responsibilities that 
are related to postpartum conditions. 
(c) PROGRAMS FOR POSTPARTUM CONDITIONS.—In 
carrying out subsection (a), the Director of the Institute 
shall conduct or support research to expand the under-
standing of the causes of, and to find a cure for,
postpartum conditions. Activities under such subsection 
shall include conducting and supporting the following: 
(1) Basic research concerning the etiology and 
causes of the conditions. 
(2) Epidemiological studies to address the fre-
quency and natural history of the conditions and the 
differences among racial and ethnic groups with re-
spect to the conditions. 
(3) The development of improved diagnostic 
techniques. 
(4) Clinical research for the development and 
evaluation of new treatments, including new biologi-
cal agents. 
(5) Information and education programs for 
health care professionals and the public. 
(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2006.
TITLE II—DELIVERY OF SERV-
ICES 
REGARDING 
POSTPARTUM 
DEPRESSION 
AND PSYCHOSIS 
SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this title referred to as the ‘‘Sec-
retary’’) shall in accordance with this title make grants 
to provide for projects for the establishment, operation, 
and coordination of effective and cost-efficient systems for 
the delivery of essential services to individuals with 
postpartum depression or postpartum psychosis (referred 
to in this section as a ‘‘postpartum condition) and their 
families. 
(b) RECIPIENTS OF GRANTS.—A grant under sub-
section (a) may be made to an entity only if the entity 
is a public or nonprofit private entity, which may include 
a State or local government; a public or nonprofit private 
hospital, community-based organization, hospice, ambula-
tory care facility, community health center, migrant health 
center, or homeless health center; or other appropriate 
public or nonprofit private entity. 
(c) CERTAIN ACTIVITIES.—To the extent practicable 
and appropriate, the Secretary shall ensure that projects 
under subsection (a) provide services for the diagnosis and
management of postpartum conditions. Activities that the 
Secretary may authorize for such projects may also in-
clude the following: 
(1) Delivering or enhancing outpatient and 
home-based health and support services, including 
case management, screening and comprehensive 
treatment services for individuals with or at risk for 
postpartum conditions; and delivering or enhancing 
support services for their families. 
(2) Delivering or enhancing inpatient care man-
agement services that ensure the well being of the 
mother and family and the future development of 
the infant. 
(3) Improving the quality, availability, and or-
ganization of health care and support services (in-
cluding transportation services, attendant care, 
homemaker services, day or respite care, and pro-
viding counseling on financial assistance and insur-
ance) for individuals with postpartum conditions and 
support services for their families. 
(d) INTEGRATION WITH OTHER PROGRAMS.—To the 
extent practicable and appropriate, the Secretary shall in-
tegrate the program under this title with other grant pro-
grams carried out by the Secretary, including the program 
under section 330 of the Public Health Service Act.