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FOR IMMEDIATE RELEASE
New Family-Focused Model of Depression Care Needed to Minimize
Risks and Problems for Parents With Depression and Their Children
Depression affects roughly 7.5 million parents -- about one in five -- in the
"To break the vicious circle of depression, we need to refocus our view of this illness through a broader lens that sees the whole family, not just the individual with depression," said committee chair and psychiatrist Mary Jane
Endeavors to increase the family focus on depression should aim to remove barriers that inhibit more coordinated care across organizations and among service providers. Children and adults are treated by separate health care providers who too often do not look at the whole family, and many health and social services are disconnected. Few programs and health care providers routinely ask patients with depression if they have children and if their depression has affected their family members. Health plans are not geared to pay for services delivered in nontraditional settings.
Fathers and mothers may benefit from counseling to improve their parenting and coping skills, and children may need treatment for emotional, behavioral, or physical problems. Services need to be available in a range of locations that include not just obstetrics-gynecology and pediatric clinics, but also Head Start facilities, schools, prisons, other community locations, and even people's homes, the report says. This means that clinicians must gain experience in delivering services in a variety of settings. States should revise policies that prohibit services outside of clinical settings. Federal agencies should establish a national program to improve the abilities of primary care providers, mental health professionals, and those who treat substance abuse to identify, treat, and prevent depression and lessen its effects on children of all ages.
Public and private health insurance plans should support access to screening, treatment, and supportive services. The Centers for Medicare and Medicaid Services (CMS) could extend Medicaid services provided to new mothers to two years after birth, which includes a critical period of early childhood development, the report says. CMS could reimburse primary care providers for mental health services and cover preventive services for children at risk of developing health problems, rather than covering only treatment. Private health plans could pay for parental depression screening and treatment, and support the implementation of effective models of depression care in a range of settings.
Lack of insurance coverage is not the only reason that two-thirds of people with depression do not get treatment. Public and private groups also need to tackle the insufficient numbers of care providers and facilities, difficulties that low-income individuals in particular confront in traveling to service providers, and the stigma associated with mental illness.
Given the variation in health and social services across states, broad experimentation with service strategies will be needed. Governors of each state should convene a task force of state and local agencies to coordinate efforts and to design and implement an array of programs involving multiple organizations and settings. State officials should document their activities and results so that they can learn from one another.
The study was sponsored by the Robert Wood Johnson Foundation, Annie E. Casey Foundation, California Endowment, U.S. Health Resources and Services Administration, and U.S. Substance Abuse and Mental Health Services Administration. The National Academy of Sciences, National Academy of Engineering,
Copies of Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above). In addition, a podcast of the public briefing held to release this report is available at http://national-academies.org/podcast.
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[ This news release and report are available at http://national-academies.org ]
NATIONAL RESEARCH COUNCIL
Board on Children, Youth, and Families
Committee on Depression, Parenting Practices, and the Healthy Development of Children
Sergio Aguilar-Gaxiola, M.D., Ph.D.
Center for Reducing Health Disparities
Kathryn E. Barnard, Ph.D., R.N.
Professor Emerita of Family and Child Nursing
William Rigby Beardslee, M.D.
Department of Psychiatry
Howard J. Cabral, Ph.D.
Department of Biostatistics
Bruce E. Compas, Ph.D.
Patricia and Rodes Hart Professor of Psychology and Human Development and Pediatrics
Patrick R. Finley, Pharm.D., B.C.P.P.
Professor of Clinical Pharmacy Pharmacology, and Behavioral Health
Sherryl H. Goodman, Ph.D.
Department of Psychology
Constance Hammen, Ph.D.
Department of Psychology
Elizabeth A. Howell, M.D., M.P.P.
Departments of Health Policy and Obstetrics, Gynecology, and Reproductive Science
Mareasa R. Isaacs, Ph.D.
Hendree Jones, Ph.D.
Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology
Jane Knitzer, Ed.D.+
New York City
Patricia O'Campo, Ph.D.
Centre for Research on Inner City Health
St. Michael's Hospital
Ardis L. Olson, M.D.
Departments of Pediatrics and Community and Family Medicine
Robert Phillips Jr., M.D., M.S.P.H.
Frank W. Putnam, M.D.
Professor of Pediatrics and Child Psychiatry
Leslie J. Sim