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PERINATAL/POSTPARTAL DEPRESSION SCREENING PROJECT. East Baton Rouge Parish Health Unit Baton Rouge, Louisiana Presented by Becky Decker, LCSW. BACKGROUND:. Infant Mental Health trainings given to OPH staff in Louisiana by Charles H. Zeanah, M.D. and Paula Zeanah, PhD., RN, MSN (2002).
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PERINATAL/POSTPARTAL DEPRESSION SCREENING PROJECT East Baton Rouge Parish Health Unit Baton Rouge, Louisiana Presented by Becky Decker, LCSW
BACKGROUND: • Infant Mental Health trainings given to OPH staff in Louisiana by Charles H. Zeanah, M.D. and Paula Zeanah, PhD., RN, MSN (2002). • Early Childhood Supports and Services Program pilot began in East Baton Rouge Parish; • OPH developed SCREENING TOOL, began screenings in EBR Health Unit (PKU visits); • High rates of maternal depression noted.
PROBLEM ISSUE TO ADDRESS: • High level of Perinatal / Postpartal Depression reported by East Baton Rouge Parish Health Unit consumers and “Healthy Start” Program clients: 33% - 38% of Health Unit respondents; 18% - 27% of Healthy Start participants.
SCIENTIFIC JUSTIFICATION: • World Health Organization: depression is one of the leading causes of disability worldwide; • Maternal depression increases risk for insecure attachment, language/cognitive problems and for social interactive problems in infancy (Lyons-Ruth, Murray, Field, Healy, et al); • Sensitive caregiving has been shown to modify infants’ negative temperament (Washington, et al, and Kagan, 1994).
OBJECTIVES: • Increase awareness of Perinatal / Postpartal illness in women; • Increase referrals for social assessment, support and treatment; • Improve medical compliance by identifying obstacle(s) to care; • Reduce incidence of childhood adjustment disorders by treating parental depression.
METHODS: • East Baton Rouge OPH collaborated with Early Childhood Supports and Services (ECSS) to implement screening tool; • MCH Central Office staff developed a 1-page questionnaire to assess social risk factors; • OPH provides staff (nursing and social work) to screen clients and provide follow-up services.
RESULTS: • Of 300 questionnaires, approximately 100 (1/3) were assessed as “high-risk” for depression or other social problems; • These clients were contacted by OPH social work staff to offer support, information and referrals; • Those in need of more comprehensive services were referred to ECSS Program (approx. 1-5%).
CONCLUSIONS: • Most women will request help for depression if asked; • Screenings for Perinatal / Postpartal illness often indicates more complex social problems at home; • More work needs to be done to develop community services to treat this illness; • Social stigma barrier must be addressed to encourage treatment for maternal depression.
PUBLIC HEALTH IMPLICATIONS: • Many new parents suffer from some degree of depressive illness (27%-33% in OPH and HS); • Maternal depression is one of the major factors shown to affect infant social development; • Clients are responsive to depression screenings in clinical settings; • Collaboration with other agencies can lead to early identification and treatment.
RESULTS ANTICIPATED: • OPH, Healthy Start and other agencies will collaborate to continue/expand screenings for Perinatal/Postpartal depression; • Community education / media awareness of this issue and its effect on children; • Reduction of stigma to ask for help; • Development of community support mechanisms (groups, phone support, etc.).
FINAL THOUGHTS: • Mental health and physical health are interconnected and should be treated with equal importance; • Creative ways to combine both aspects of health in health care settings should be explored; • Continued collaboration with other programs are planned to address depression, substance abuse and domestic violence in the community.
