— His family owned pizza shops. Hers owned McDonald’s
franchises. In 2008, at a mutual friend’s birthday party in
Miami, Alexis Joy Micale "walked in, and I knew that she
was going to be my wife," said Steven D’Achille.
few months later, D’Achille was driving to New Jersey to
move in with the then-Ms. Micale, calling her father from the
car on the way there to ask for his daughter’s hand in
were married in the fall of 2009 and moved to Pittsburgh’s
Bloomfield neighborhood after the wedding so that he could
join his family’s business. She began a job she loved,
selling houses with Ryan Homes, working with families "to
build their dream homes," said Mr. D’Achille.
were thrilled to find out in late 2012 that they were
expecting a child. "We got pregnant so easy, and the
pregnancy was so easy," said D’Achille, who now lives
in McCandless, Penn. "It was too good to be true."
daughter, Adriana, was born Aug. 30, 2013. Six weeks later,
Alexis Joy D’Achille committed suicide. Despite "never
a day in her life" having mental health problems before
her daughter’s birth, the 30-year-old suffered severe
postpartum depression, starting when her daughter was about 3
sitting in the office of his lawyer, John Gismondi, declined
to share details of his wife’s final weeks in anticipation
of filing a lawsuit about her care.
weeks after her death, he began to raise money to promote
awareness of the disease. From events as big as a gala at the
Fairmont Hotel and as small as contributions from a mom’s
group, donations poured in.
first 18 months, the Alexis Joy Foundation raised $250,000,
giving $100,000 of that sum to Allegheny Health Network this
spring as a planning grant for research, prevention and
treatment of postpartum depression.
ultimate goal, for Steven D’Achille, is for the group
"to one day be the leading perinatal mood disorder
program in the country."
already been thinking about ways to improve care for women
with postpartum depression. "We’ve been talking about
it for a long time," said Deborah Linhart, vice president
of women’s health initiatives. "His story resonated so
much it became really a call to arms."
analysis of Highmark data that tracked 1,000 women from the
start of their pregnancy over an 18-month period found that 22
percent had a diagnosis of depression. "The number sounds
so high because people kept it to themselves," said
Linhart. "A part of it is destigmatizing this, making
people aware that this really can happen."
depression, marked by symptoms such as confusion, sadness,
hopelessness and guilt, can initially be difficult to
distinguish from the "baby blues," a short-lived
condition that affects up to 70 percent of new mothers. While
the baby blues generally clears within a week or two,
postpartum depression persists. It is most common in the three
months after birth, although symptoms could start showing up
as long as a year later.
relatively few cases of postpartum depression are as severe as
Alexis D’Achille’s, many more women could benefit from
getting treatment, even for milder cases. "Not all
postpartum depression ends in tragedy, but it’s a lot of
pain and suffering that can be avoided, and it’s not good
for the infant," said P.V. Nickell, assistant chair for
psychiatry at Allegheny Health Network.
starting to work with Steven D’Achille this spring, AHN has
distributed about 5,000 copies of a brochure, "Alexis’
Story," with information about signs of postpartum
depression and resources for treatment. The brochure is being
distributed at childbirth classes, obstetricians’ offices,
hospital discharges and well-baby visits.
Steven, the brochures will help reach people who might think
they’re not at risk for the disease. His wife had a
relentlessly sunny personality, with no history of depression
before or during her pregnancy. "Alexis was the last
person in the world that anyone could think this could happen
to," he said. "This kind of depression, it knows no
hospital system will also soon be piloting a triage program,
using telemedicine to immediately assess women identified by
their obstetrician or other doctor as having symptoms of
postpartum depression. AHN has hired a dedicated psychologist
and clinical social worker who will work with three ob-gyn
practices participating in the trial. Women identified by the
ob-gyns will be immediately seen, while still in their doctors’
offices, via a video-conferencing program by the triage
psychological staff. They will then be referred for treatment,
whether it be medication, outpatient or inpatient care.
AHN is hoping to expand the screening and telemedicine to
pediatricians’ offices as well, where new mothers often have
more points of contact.
at AHN, including Steven D’Achille, has also gone on site
visits to leading programs nationally in treating postpartum
depression. The group is particularly interested in treatment
options that allow the mother to stay bonded to her baby.
"We want to identify the problems that kept people,
especially Alexis, from getting the care she needed in a
timely manner," said Dr. Nickell. "A mother might
say, ‘I don’t want to leave my baby and go to this partial
hospital program.’ We visited a program at Brown University
that we’re going to try to reproduce here, a partial
hospital for moms with young babies where they bring their
baby with them — that’s on the drawing board."
handful of such programs exist in the U.S., he said, although
allowing mothers to bring their babies with them to treatment
facilities is more common in Europe.
fundraising efforts will continue as well. As Adriana’s
second birthday approaches, the foundation will hold the Run
for Joy 5K and one mile fun run at an area boathouse on Aug.
has inherited her mother’s "total spitfire"
personality, he says, and she loves to swim. His wife, he
said, was happiest when cigarette boating on the Jersey Shore.
impact of program with AHN, he hopes, is something that will
further connect mothers and daughters.
she excelled at everything she did," said Steven. "I
wanted something for Adriana to be proud of her mom for. Her
mom will make a difference in so many women’s lives."