This Didn’t Have to Happen. You Can Help.

The non-profit organization Maternal Mental Health NOW has launched a significant advocacy campaign directed at the Los Angeles County Board of Supervisors, calling for immediate systemic reforms following the high-profile tragedy involving Liliana Carrillo. The organization is demanding that the county mandate comprehensive training on perinatal mood and anxiety disorders (PMADs) for employees across all county agencies and departments. Furthermore, the group is seeking the establishment and funding of a coordinated system of care designed to provide high-quality, culturally appropriate, and easily accessible mental health services to new and expecting parents. The move comes as advocates argue that existing gaps in the county’s social and medical safety nets have resulted in preventable tragedies, highlighting a desperate need for a more proactive and integrated approach to maternal wellness.

The Catalyst: The Liliana Carrillo Case and Systemic Failures

The urgency of this policy push is rooted in the April 2021 tragedy in Reseda, California, where Liliana Carrillo was arrested following the deaths of her three young children: Joanna, Terry, and Sierra, aged 3, 2, and six months, respectively. The case sent shockwaves through Southern California and ignited a fierce debate over how the legal and healthcare systems handle mothers experiencing severe mental health crises.

Investigations into the family’s history revealed a complex and deteriorating situation. In the months leading up to the tragedy, the children’s father, Erik Denton, had sought emergency custody, citing concerns about Carrillo’s mental stability. Court documents and reports indicated that Carrillo was struggling with severe postpartum depression and potentially postpartum psychosis, a rare but dangerous condition characterized by delusions and a break from reality. Despite multiple interactions with the legal system and social services, the family remained in a state of high-risk limbo.

Advocates point to this case as a definitive example of "siloed" care, where different county departments—ranging from the Department of Children and Family Services (DCFS) to the court system and law enforcement—fail to communicate effectively regarding the nuances of perinatal mental health. Maternal Mental Health NOW asserts that if county employees across these various touchpoints had been properly trained to recognize the signs of PMADs and if a coordinated referral system had been in place, the outcome for the Carrillo children might have been different.

Chronology of a Crisis: The Timeline of Advocacy

The push for a county-wide mandate has developed through several key phases following the 2021 Reseda incident:

1. April 2021: The discovery of the Carrillo children leads to immediate public outcry. Maternal health experts begin highlighting the lack of screening and intervention for postpartum psychosis.
2. May 2021 – Late 2022: Advocacy groups, led by Maternal Mental Health NOW, begin drafting policy recommendations. They focus on the concept of "cultural appropriateness," noting that mothers from diverse backgrounds often face additional barriers to seeking help due to stigma or fear of child removal by the state.
3. Early 2023: The Board of Supervisors, which for the first time in history is composed entirely of female identifying members, becomes the primary target for legislative change. Advocates argue that this historic board is uniquely positioned to understand and prioritize maternal health issues.
4. Present Day: The "Action Alert" is issued to the public, encouraging constituents to contact their supervisors directly. The goal is to move from awareness to a formal board motion that carries the weight of law and budget allocation.

Supporting Data: The Scope of Perinatal Mental Health Disorders

To support their demands, advocates have presented a wealth of data regarding the prevalence and impact of PMADs. According to the Centers for Disease Control and Prevention (CDC) and various maternal health studies, approximately one in five to one in seven women experience some form of perinatal depression or anxiety.

In Los Angeles County, where birth rates remain significant despite statewide declines, this translates to thousands of families annually. Furthermore, research indicates that:

• Postpartum Psychosis: While rare, occurring in approximately 1 to 2 out of every 1,000 births, it is a medical emergency with a high risk of infanticide or suicide if untreated.
• The Gap in Screening: Studies suggest that fewer than 50% of women with PMADs are ever formally diagnosed, and of those, only a fraction receive adequate follow-up care.
• Economic Impact: Untreated maternal mental health conditions are estimated to cost the U.S. billions of dollars annually in lost productivity, increased social service utilization, and long-term developmental impacts on children.
• Racial Disparities: Women of color are statistically less likely to receive mental health treatment and more likely to face punitive measures rather than supportive interventions when struggling with mental health issues.

Maternal Mental Health NOW emphasizes that these statistics are not just numbers but represent a preventable public health crisis that requires a multi-agency response.

The Board of Supervisors: A Historic Opportunity for Reform

The Los Angeles County Board of Supervisors serves as the executive, legislative, and quasi-judicial governing body for over 10 million residents. With a budget exceeding $40 billion, the board oversees the departments most critical to the maternal health infrastructure, including the Department of Health Services, the Department of Mental Health, and DCFS.

The current board composition is historically significant:

• First District (Supervisor Hilda Solis): Representing areas such as Azusa, El Monte, and portions of Los Angeles, Solis oversees a district with high populations of working-class families who often rely on county health clinics.
• Second District (Supervisor Holly Mitchell): Representing Carson, Compton, and Inglewood, Mitchell has been a vocal advocate for "Black Maternal Health" and addressing the disparities in healthcare outcomes for women of color.
• Third District (Supervisor Lindsey P. Horvath): Representing Malibu, Santa Monica, and West Hollywood, Horvath’s district includes significant advocacy and healthcare hubs.
• Fourth District (Supervisor Janice Hahn): Representing the South Bay and Gateway Cities, Hahn has long focused on community-based safety and health services.
• Fifth District (Supervisor Kathryn Barger): Representing the Antelope and San Gabriel Valleys, Barger has often focused on the intersection of mental health and public safety.

Advocates argue that because all five supervisors are women, there is an unprecedented window of empathy and political will to address issues that were historically marginalized as "women’s issues" rather than "public health mandates."

Proposed Policy Changes and Implications

The motion being sought by Maternal Mental Health NOW includes several specific pillars:

Mandatory Departmental Training

The proposal requires that every county employee who interacts with families—including social workers, sheriff’s deputies, court clerks, and public health nurses—undergo training to identify the symptoms of PMADs. This training would focus on moving away from punitive responses (such as immediate child removal) toward clinical and supportive interventions.

A Coordinated System of Care

Rather than families having to navigate a labyrinth of different agencies, the proposed system would create a "warm hand-off" protocol. If a mother shows signs of distress during a routine WIC appointment or a court hearing, the system would trigger an immediate referral to a specialized perinatal mental health provider within the county network.

Funding for Culturally Appropriate Treatment

A significant portion of the demand involves financial investment. This includes funding for bilingual therapists, peer support groups, and community-based organizations that understand the specific cultural stigmas associated with mental health in various Los Angeles neighborhoods.

Broader Impact and Future Outlook

The implications of such a mandate in Los Angeles County could be national in scope. As the most populous county in the United States, Los Angeles often serves as a laboratory for social policy. If the Board of Supervisors passes a comprehensive perinatal mental health mandate, it could set a precedent for other counties and states to follow.

The move also represents a shift in how society views maternal responsibility and mental illness. By framing PMADs as a systemic issue requiring a coordinated governmental response, advocates are attempting to reduce the shame and isolation that often prevents mothers from seeking help.

Executive Director Kelly O’Connor of Maternal Mental Health NOW has emphasized that the goal is to ensure that "all of LA County’s growing families have access to timely, informed, and culturally appropriate perinatal mental health care." The organization believes that by empowering constituents to contact their supervisors directly, the collective voice of the community can force a change in how the county protects its most vulnerable residents.

As the Board of Supervisors considers these demands, the eyes of maternal health advocates nationwide remain on Los Angeles. The successful implementation of these reforms would not only honor the memory of those lost in the Carrillo tragedy but would fundamentally alter the landscape of family support services for generations to come. For now, the "Action Alert" remains active, with the organization urging residents to use their voices to ensure that a tragedy of this magnitude never occurs again within the boundaries of Los Angeles County.