1. 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

2. 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

3. 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

4. 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

5. Toolkit Project Values: Health Promoting Mental Health Literacy Community Informed Family Centered Strengths Based Support Enhancing Knowledge Sharing Collaborative Care & Intervention

6. 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

7. Promoting Mothers’ Mental Health Well Mother Healthy Child Strong Community

8. Mother’s Mental Health Critical to Infant Attachment & Development

9. Infant Attachment & Development Contributes to Risk of Child Mental Illness & Behaviour Problems

10. 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

12. How is the Toolkit Organized?

15. 95

16. How is the Toolkit Organized? 100

17. 1. Mothers’ Wellness & Self-Care

18. Mothers’ Wellness & Self-Care 17

19. Mothers’ Wellness & Self-Care 19

20. 2. The Mothering Role

21. The Mothering Role 51

22. The Mothering Role 61

23. The Mothering Role 62

24. 3. Understanding Mothers’ Mental Health

25. Understanding Mothers’ Mental Health 94

26. Understanding Mothers’ Mental Health 109

27. Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy

28. 118

29. Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 119

30. Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 122

31. Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy 129

32. 4. Assessment & Screening

33. Assessment & Screening 137

34. Assessment & Screening 139

35. 5. Interventions & Treatments 5. Interventions & Treatments

36. Interventions & Treatments 141

37. 6. Supporting Recovery

38. Supporting Recovery 152

39. Supporting Recovery 156