Five actions on maternal depression

While about 1 in 8 new mothers report symptoms of postpartum depression, the rates are much higher in families with lower incomes. 52% of mothers in the Early Head Start research study reported high levels of depressive symptoms (Administration for Children and Families, 2002).

Maternal depression interferes with a mother’s ability to be responsive to her new babies and makes parenting toddlers and preschoolers more difficult. Head Start programs have a lot of resources available to them to address this issue.

Here are some action steps and resources that programs can take to reduce the impact of depression in the families they serve.

• Identify families in need of support through validated screening tools
• Train staff about depression warning signs and how to talk with families
• Provide reflective supervision for staff working with families who have mental health challenges
• Connect families with community-based treatment services
• Reduce stigma by promoting awareness of depression as a common and treatable condition

Jump to any step to read more and find resources for working with mothers and their families.

1. Identify families in need of support through validated screening tools

There are a number of valid and reliable screening tools to help Head Start programs identify families who may be experiencing depressive symptoms. Below we have listed some of the most commonly used tools. Many of these tools are available for free. There is also a PDF version of this list that can be downloaded to share with others. Also review the screenings of children whose parents are experiencing depression, since it can affect the child's social and emotional development too.

Resources

• Choose and Use Guide for Social and Emotional Assessment Center for Early Childhood Mental Health Consultation
• Inventory of maternal depression screening tools (PDF)

2. Train staff about depression warning signs and how to talk with families

The Office of Head Start has funded many projects that can help programs prepare staff to work with families who are experiencing depression. One of these projects is Family Connections at Children’s Hospital Boston, which developed a full training curriculum for Head Start staff. Below are modules and materials that can support professional development in this area. Depression may look different in men and women, and in people from different backgrounds and cultures.

Resources

• Training Modules for Staff , 2008, Family Connections Materials: Module One The Benefits and Challenges of Engaging Parents
• Perspective Taking
• What Is Depression?
• Module Two: The Program Climate and You
• Accentuate the Positive
• What Is Depression?
• Module Three: Supporting Social/Emotional Growth
• Strategies for Talking to Children about Difficult Issues
• Using Reading and Circle Time to Promote an Expressive Environment
• Module Four: Better Communication
• Developing a Resource and Referral Process
• Getting the Most from the Home Visit
• Papers from Family Connections Program : The Challenges and Benefits of Making Parent Connections
• Parenting, Depression, and Hope
• Reaching out to families facing adversity
• Fostering Resilience in Families Coping with Depression: Practical ways Head Start staff can help families build on their power to cope.
• Understanding Depression across Cultures
• Better Communication with Children: Responding to challenging subjects
• Better Parent Communication: What do I say when a parent tells me something difficult?
• Encouraging an Expressive Environment: Supportive communication from the inside out

3. Provide reflective supervision for staff working with families who have mental health concerns

When staff works with families who are experiencing depression or other mental health concerns, they may need some additional support and guidance from their supervisors. Reflective supervision can help staff: to gain insight into how the families’ stress and depression might be affecting their own mental health; to maintain appropriate boundaries in their help-giving roles; and to prevent burnout by providing a safe place to talk about their feelings and challenges. Taking care of others means taking care of yourself.

Resources

• Supportive Supervision: Promoting staff and family growth through positive relationships , 2008, Family Connections
• Reflective Supervision: A Tool for Relationship-based Early Head Start Services, 2010, Early Head Start National Resource Center
• Reflective Supervision: Putting It Into Practice (webcast), Early Childhood Learning & Knowledge Center

4. Connect families with community-based treatment services

Head Start programs provide a wide range of services and supports for families and young children; but for some families who are experiencing mental health concerns, a referral for treatment services may be necessary. Making a good referral involves a number of steps: knowing who needs a more intensive level of services; knowing what resources are available in your community; and having procedures in place to help families follow-up and get the care they need. It helps to have a relationship with the community agency you refer families to.

Resources

• The Best Beginning: Partnerships Between Primary Health Care and Mental Health and Substance Abuse Services for Young Children and Their Families 2005, Georgetown University National Center for Children’s Mental Health.

5. Reduce stigma by promoting awareness of depression as a common and treatable condition

Despite the prevalence of depression in the United States, there is still stigma about mental health. Families may be reluctant to admit they are feeling depressed and be afraid to follow through on referrals for treatment. Staff can help reduce the stigma of depression by talking about mental health in the same way they talk about other physical health concerns. There are posters that you can use to increase awareness about how common and treatable depression is. Head Start can play an important role in showing parents how much their mental health matters to their children.

Resources

• Review of Current Literature , 2000, Administration for Children and Families
• Research Brief No. 13: Depression Among Caregivers of Young Children Reported for Child Maltreatment , 2002, Administration for Children and Families
• Improving Maternal and Infant Mental Health: Focus on Maternal Depression , 2005, Zero to Three
• Understanding Depression across Cultures , 2008, Family Connections
• Maternal Depression Posters: Maternal Posters | Family Poster | Provider Poster , 2013, Center for Early Childhood Mental Health Consultation