Maternal Mental Health: Preventing & Mitigating Its Effects Robin C. Kopelman, M.D., M.P.H. University of Iowa Department of Psychiatry Women’s Wellness.

Maternal Mental Health:Maternal Mental Health:Preventing & Mitigating Preventing & Mitigating

Its EffectsIts EffectsRobin C. Kopelman, M.D., M.P.H.Robin C. Kopelman, M.D., M.P.H.

University of Iowa Department of PsychiatryUniversity of Iowa Department of PsychiatryWomen’s Wellness & Counseling ServiceWomen’s Wellness & Counseling Service

Iowa Depression and Clinical Research CenterIowa Depression and Clinical Research CenterACES October 14, 2013ACES October 14, 2013

Maternal depression is common – 30% Maternal depression is common – 30% or more in select Iowa populationsor more in select Iowa populations

Series of negative Series of negative consequencesconsequences

Impact on Family Partner Marital discord, divorce Family violence

Less likely to engage in healthy

parenting practices Difficulties managing children’s health

Personal suffering of woman

Series of negative Series of negative consequencesconsequences

Impairment of factors key for healthy early Impairment of factors key for healthy early brain development, including before birthbrain development, including before birth

NeglectNeglectHigher risk for developmental, behavioral, Higher risk for developmental, behavioral, cognitive & emotional problems in childrencognitive & emotional problems in children

Cycle of depressionCycle of depressionCombined with poverty, substance abuse, Combined with poverty, substance abuse, domestic violence, or traumadomestic violence, or trauma

Impact is even greaterImpact is even greater

Addressing maternal depressionAddressing maternal depression

We must (continue) todo something about We must (continue) todo something about this!this!

IdentificationIdentification

TreatmentTreatment

PreventionPrevention

Identify Maternal DepressionIdentify Maternal Depression

Screening increases detection!Screening increases detection!

ACOG strongly encourages screeningACOG strongly encourages screening

AAP recommends screeningAAP recommends screening

Iowa efforts have been strongIowa efforts have been strong

The good news…The good news…

Treatment of maternal depression is Treatment of maternal depression is associated with improved outcomes for associated with improved outcomes for their children!their children! Plus…dads/partners may help.Plus…dads/partners may help.

Significance of Paternal DepressionSignificance of Paternal Depression

Non-depressed fathers may “buffer” Non-depressed fathers may “buffer” effects of maternal depressioneffects of maternal depression Social supportSocial support Increased infant-parent interactionIncreased infant-parent interaction

Paternal & Caregiver depressionPaternal & Caregiver depression Similar to effects of maternal depressionSimilar to effects of maternal depression

Addressing Caregiver Addressing Caregiver DepressionDepression

Improve mechanisms to screen fathers for Improve mechanisms to screen fathers for depressiondepression Direct and Direct and ProxyProxy screening screening

Improve mechanisms to screen AND Improve mechanisms to screen AND address depression in all caregiversaddress depression in all caregivers

Beyond screening…critical links Beyond screening…critical links to treatment and preventionto treatment and prevention

Follow-up and capacity to treatFollow-up and capacity to treat Consultation servicesConsultation services # of and type of provider# of and type of provider

AwarenessAwareness PublicPublic CommunitiesCommunities ProvidersProviders

Critical LinksCritical Links

Targeted interventionsTargeted interventions Home visiting and Family based programsHome visiting and Family based programs ““Preventive ‘treatment”Preventive ‘treatment” Novel treatment modelsNovel treatment models

Critical LinksCritical Links

PolicyPolicy Screening promotionScreening promotion

Address access (includingAddress access (including financial financial))• Targeted interventionsTargeted interventions• Mental Mental healthcarehealthcare for parenting women for parenting women

Iowa ResourcesIowa Resources

Iowa ResourcesIowa Resources

What’s available for Iowa womenWhat’s available for Iowa womenand providers in the maternaland providers in the maternalmental health field?mental health field?

Education, Consultation and Support for Education, Consultation and Support for Screening, Referral, and Treatment Screening, Referral, and Treatment

Clinical and Treatment ResourcesClinical and Treatment Resources Women’s Wellness & Counseling Service: (319-335-Women’s Wellness & Counseling Service: (319-335-

2464), http://www.uihealthcare.org/womenswellness/2464), http://www.uihealthcare.org/womenswellness/ Research InitiativesResearch Initiatives

Maternal Depression: Maternal Depression: Prevention & Mitigation – Prevention & Mitigation –

Suggested ReadingSuggested Reading

http://www.nccp.org/publications/pub_791.htmlhttp://www.nccp.org/publications/pub_791.html

http://www.modernmedicine.com/modern-http://www.modernmedicine.com/modern-medicine/news/modernmedicine/modern-medicine/news/modernmedicine/modern-medicine-feature-articles/reducing-maternal-medicine-feature-articles/reducing-maternal-depression-andepression-an