1. 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

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. 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

4. Who Funded This? The Public Health Agency of Canada: National Projects Fund

5. Who Was This Developed For
Who Was This Developed For? CAPC/CPNP Projects & Community Service Providers to Mothers and Families

6. 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

7. 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

8. 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

9. What are the Project Values?

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

11. Your Values in Work with Mothers?

12. Elements of Vulnerability for Maternal Mental Health Problems

13. 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

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

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

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

17. 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

18. 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

20. How is the Toolkit Organized?

21. How is the Toolkit Organized?

22. How is the Toolkit Organized?

23. How is the Toolkit Organizer?
Long Side Bar
Service Providers
Short Side Bar
Mother Participants

24. How is the Toolkit Organized?95

25. How is the Toolkit Organized?96

26. How is the Toolkit Organized?
100

27. 1. Mothers’ Wellness & Self-Care

28. Mothers’ Wellness & Self-Care17

29. Mothers’ Wellness & Self-Care19

30. Mothers’ Wellness & Self-Care29

31. Mothers’ Wellness & Self-Care35

32. 2. The Mothering Role

33. The Mothering Role 51

34. The Mothering Role 52

35. The Mothering Role 53

36. The Mothering Role 54

37. The Mothering Role 61

38. The Mothering Role 62

39. 3. Understanding Mothers’ Mental Health

40. Understanding Mothers’ Mental Health94

41. Understanding Mothers’ Mental Health
109

42. Understanding Mothers’ Mental Health
115

43. Understanding Mothers’ Mental Health
116

44. Understanding Mothers’ Mental Health
117

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

46. Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy
118

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

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

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

50. Signs & Symptoms/Diagnostic Possibilities: A Model of Mental Health Literacy
130

51. 4. Assessment & Screening

52. Assessment & Screening
137

53. Assessment & Screening
139

54. 5. Interventions & Treatments

55. Interventions & Treatments
141

56. 6. Supporting Recovery

57. Supporting Recovery
152

58. Supporting Recovery
156

59. 7. Community Action

60. Community Action
159

61. Lessons Learned

62. Windows of Opportunity

63. The Path We’re On

64. Contact
Reproductive Mental Health Service IWK Health Centre, Halifax (902) Fax: (902)