MOTHERS’ MENTAL HEALTH TOOLKIT A Project of the Reproductive Mental Health Service IWK Health Centre Halifax NS, Public Health Agency of Canada & CAPC/CPNP Projects Across Canada A Community-Based Collaborative Initiative
Mothers’ Mental Health Toolkit The Project Team Dr. Joanne MacDonald Psychiatrist/Project Lead Coleen Flynn, MSW RSW Clinician Therapist Content Lead Tana Woodward, MSW RSW Training Development Kim D’Ambrogi Admin/Project Support
Reproductive Mental Health Service: What We Do Mental Health Care for Mothers Priority on Pregnancy and Year After Birth Atlantic Interdisciplinary Specialty Mental Health Team Psychiatry, Nursing, Social Work, Psychology, Occupational Therapy & Addictions Community Collaborative Practice Focus Professional & Community Education and Advocacy
Who Funded This? The Public Health Agency of Canada: National Projects Fund
Who Was This Developed For Who Was This Developed For? CAPC/CPNP Projects & Community Service Providers to Mothers and Families
What’s In This Toolkit? Maternal Mental Health Education for Community Service Providers Worksheets for Use with Mothers Wellness to Illness Recognition Resources for Mothers and their Caregivers
What Isn’t In the Toolkit? Depth of Diversity Applications Cultural Specificity Mental Health Treatment or Intervention Limited Rural/Remote Tools Languages Other than Eng/Fr Replacements for MH Services
What’s The Project Timeline? January 2012-December 2013 3 Phases: 1. Toolkit Revision/National Applicability 2. Development of Training Modalities 3. Dissemination & Training Delivery
What are the Project Values?
Toolkit Project Values: Health Promoting Mental Health Literacy Community Informed Family Centered Strengths Based Support Enhancing Knowledge Sharing Collaborative Care & Intervention
Your Values in Work with Mothers?
Elements of Vulnerability for Maternal Mental Health Problems
Vulnerability & Risk Determinants Poverty Low level of support Family conflict/disruption Trauma Poor housing Transportation limitations Education deficits Unemployment Previous Mental Health Problem Family History of Mental Illness/Addictions
Promoting Mothers’ Mental Health Well Mother Healthy Child Strong Community
Mother’s Mental Health Critical to Infant Attachment & Development
Infant Attachment & Development Contributes to Risk of Child Mental Illness & Behaviour Problems
Maternal Mental Health Problems Mental Health Diagnosis Pre-Pregnancy New Mental Health Problem During Pregnancy or First Year After Birth Severe Adjustment Difficulties Personality Disorders Post-Traumatic Stress Disorder Spectrum Concurrent Addictions Attachment Disturbances Complex Case/High Risk Contributors
Who Do We Use the Toolkit For? Jody: 19 yo Bi-racial (Caucasion & African Nova Scotian) Pharmacy student on scholarship Parenting 1 and 3 yo girls Ex-partner ? drug dealing, threatening, manipulative Public housing with mother, 4 yo sister and children Mother hx emotional dysregulation & physical violence Biological Father – Africa American, left < 3 yo Brother physical violence to Jody & Mother, incarcerated Hx obsessional rumination & counting habit 10 yo Baseline anxious temperament – GAD Postpartum – ‘new’ explosive rage & depressive sx
How is the Toolkit Organized?
How is the Toolkit Organized?
How is the Toolkit Organized?
How is the Toolkit Organizer? Long Side Bar Service Providers Short Side Bar Mother Participants
How is the Toolkit Organized? 95
How is the Toolkit Organized? 96
How is the Toolkit Organized? 100
1. Mothers’ Wellness & Self-Care
Mothers’ Wellness & Self-Care 17
Mothers’ Wellness & Self-Care 19
Mothers’ Wellness & Self-Care 29
Mothers’ Wellness & Self-Care 35
2. The Mothering Role
The Mothering Role 51
The Mothering Role 52
The Mothering Role 53
The Mothering Role 54
The Mothering Role 61
The Mothering Role 62
3. Understanding Mothers’ Mental Health
Understanding Mothers’ Mental Health 94
Understanding Mothers’ Mental Health 109
Understanding Mothers’ Mental Health 115
Understanding Mothers’ Mental Health 116
Understanding Mothers’ Mental Health 117
Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy
Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 118
Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 119
Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 122
Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 129
Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 130
4. Assessment & Screening
Assessment & Screening 137
Assessment & Screening 139
5. Interventions & Treatments
Interventions & Treatments 141
6. Supporting Recovery
Supporting Recovery 152
Supporting Recovery 156
7. Community Action
Community Action 159
Lessons Learned
Windows of Opportunity
The Path We’re On
Contact Reproductive Mental Health Service IWK Health Centre, Halifax (902) 470-8098 Fax: (902) 470-6760 Email: joanne.macdonald@iwk.nshealth.ca