1. Maternal Mental Health: Preventing & Mitigating Its Effects Robin C. Kopelman, M.D., M.P.H. University of Iowa Department of Psychiatry Women’s Wellness & Counseling Service Iowa Depression and Clinical Research Center ACES October 14, 2013

2.  Maternal depression is common – 30% or more in select Iowa populations

3. Series of negative consequences   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

4. Series of negative consequences  Impairment of factors key for healthy early brain development, including before birth Neglect Neglect  Higher risk for developmental, behavioral, cognitive & emotional problems in children Cycle of depression Cycle of depression  Combined with poverty, substance abuse, domestic violence, or trauma Impact is even greater Impact is even greater

5. Addressing maternal depression  We must (continue) todo something about this! Identification Identification Treatment Treatment Prevention Prevention

6. Identify Maternal Depression  Screening increases detection!  ACOG strongly encourages screening  AAP recommends screening  Iowa efforts have been strong

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

8. Significance of Paternal Depression  Non-depressed fathers may “buffer” effects of maternal depression Social support Social support Increased infant-parent interaction Increased infant-parent interaction  Paternal & Caregiver depression Similar to effects of maternal depression Similar to effects of maternal depression

9. Addressing Caregiver Depression  Improve mechanisms to screen fathers for depression Direct and Proxy screening Direct and Proxy screening  Improve mechanisms to screen AND address depression in all caregivers

10. Beyond screening…critical links to treatment and prevention  Follow-up and capacity to treat Consultation services Consultation services # of and type of provider # of and type of provider  Awareness Public Public Communities Communities Providers Providers

11. Critical Links  Targeted interventions Home visiting and Family based programs Home visiting and Family based programs “Preventive ‘treatment” “Preventive ‘treatment” Novel treatment models Novel treatment models

12. Critical Links  Policy Screening promotion Screening promotion Address access (including financial) Address access (including financial) Targeted interventionsTargeted interventions Mental healthcare for parenting womenMental healthcare for parenting women

13. Iowa Resources

14.  What’s available for Iowa women and providers in the maternal mental health field?  Education, Consultation and Support for Screening, Referral, and Treatment  Clinical and Treatment Resources Women’s Wellness & Counseling Service: (319-335- 2464), http://www.uihealthcare.org/womenswellness/ Women’s Wellness & Counseling Service: (319-335- 2464), http://www.uihealthcare.org/womenswellness/  Research Initiatives

15. Maternal Depression: Prevention & Mitigation – Suggested Reading  http://www.nccp.org/publications/pub_791.html http://www.nccp.org/publications/pub_791.html  http://www.modernmedicine.com/modern- medicine/news/modernmedicine/modern- medicine-feature-articles/reducing-maternal- depression-an http://www.modernmedicine.com/modern- medicine/news/modernmedicine/modern- medicine-feature-articles/reducing-maternal- depression-an http://www.modernmedicine.com/modern- medicine/news/modernmedicine/modern- medicine-feature-articles/reducing-maternal- depression-an