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.

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.