PERINATAL/POSTPARTAL DEPRESSION SCREENING PROJECT

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PERINATAL/POSTPARTAL DEPRESSION SCREENING PROJECT

• East Baton Rouge Parish Health Unit
• Baton Rouge, Louisiana
• Presented by Becky Decker, LCSW

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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.

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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.

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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).

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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.

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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.

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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).

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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.

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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.

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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.).

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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.