Experiencing intense anxiety, lethargy, irritability, or sadness can be debilitating when trying to accomplish a simple task. For the task as monumental as caring for a baby, these symptoms of perinatal mood and anxiety disorders (PMADs) affect one in five mothers, many who feel unsupported.

In a new study, researchers surveyed hundreds of caregivers across the US about their mental health; networks of support; and experiences with caregiving, the healthcare system, and the workplace. They found that caregivers broadly experienced a lack of support in terms of PMAD screenings and mental healthcare, access to specialists, a lack of familial support, and inadequate paid leave.

“These findings confirm what families and advocates have been saying for years: our fragmented system is failing parents at one of the most vulnerable times in their lives. Too often, caregivers experiencing PMADs suffer in silence. Our data show that many are never screened by their providers, leaving them to navigate serious mental health challenges on their own,” says lead author Erin O’Connor, professor of education and director of NYU Steinhardt’s Early Childhood Education Program.

O’Connor and her co-author, Robin Neuhaus, conducted the study through Nested, a nonprofit they co-founded to advance family wellbeing through research-driven solutions. The report—Missed Screenings, Missed Support—draws on data from more than 900 survey respondents and 17 in-depth interviews, and highlights the need for more training for healthcare providers, increased access to health services and supportive networks, and expanded paid leave.