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PERINATAL

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

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PERINATAL

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    1. PERINATAL/POSTPARTAL DEPRESSION SCREENING PROJECT East Baton Rouge Parish Health Unit Baton Rouge, Louisiana Presented by Becky Decker, LCSW

    2. 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. Concept of Infant Mental Health focuses on RELATIONSHIP BETWEEN BABIES AND PRIMARY CAREGIVERS (single most imp. Factor in creating healthy social development and early cognitive development). Other states doing this already: Florida, Calif., etc. The screening tool was dev. By MCH/OPH physician with P. Zeanah, and it tried to capture social/environmental FACTORS may influence bonding. MATERNAL DEPRESSION jumped-out! Concept of Infant Mental Health focuses on RELATIONSHIP BETWEEN BABIES AND PRIMARY CAREGIVERS (single most imp. Factor in creating healthy social development and early cognitive development). Other states doing this already: Florida, Calif., etc. The screening tool was dev. By MCH/OPH physician with P. Zeanah, and it tried to capture social/environmental FACTORS may influence bonding. MATERNAL DEPRESSION jumped-out!

    3. 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.

    4. 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).

    5. 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.

    6. 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.

    7. 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%).

    8. 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.

    9. 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.

    10. 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.).

    12. 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.

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