1. Perinatal Foundation, Inc. Breakfast Forum on Perinatal Depression October 26, 2004 Concourse Hotel, Madison, WI Ann Conway, RN, MS, MPA Executive Director, Perinatal Foundation Cara Hansen, Director of Community Outreach Mental Health Association in Milwaukee Co.

2. Perinatal Foundation, Inc. What Is Perinatal Depression?

3. Perinatal Foundation, Inc. Signs and Symptoms Depressed mood Tearfulness Sleep or appetite disturbances Weight gain or loss Hopelessness Loss of interest & pleasure Feelings of being overwhelmed Guilt Anxiety or nervousness Irritability Low energy Loss of concentration Thoughts of harming self or infant

4. Perinatal Foundation, Inc. Incidence of Perinatal Depression 10% - 15% of women experience depression in the perinatal period and up to 28% of women living in poverty. There were 68,510 births in Wisconsin in 2002. That means that (10 –15%) over 6,800 to 10,000 women were likely to suffer from prenatal and postpartum depression.

5. Perinatal Foundation, Inc. Depression affects how a woman is able to relate to: her baby her family her friends, and her co-workers

6. Perinatal Foundation, Inc. “You Can’t Tell by Looking” that someone has depression. Approximately 50% of women with PPD are untreated. Those caring for women & children from pregnancy through the first year of life should be alert to the symptoms of perinatal mood disorders. Routine screening by primary care providers is essential.

7. Perinatal Foundation, Inc. Depression is treatable Depression may not resolve without treatment. When treated, women do recover and return to their roles and responsibilities at home and at work. Studies show that employees who have been diagnosed with depression and treated have no significant differences in their performance than those without depression.

8. Perinatal Foundation, Inc. Treatment Options for PPD - 1 Non-clinical interventions “Simple Things You Can Do” Exercise Diet Rest Rethinking expectations Social support Family support

9. Perinatal Foundation, Inc. Treatment Options for PPD - 2 Clinical Therapies Decision between the woman and her physician after a risk/benefit analysis of her situations Medications Psychotherapy (interpersonal or cognitive-behavioral) Combination

10. Perinatal Foundation, Inc. Consequences of Untreated Depression Woman may not seek prenatal care or follow through on health care recommendations May be less responsive to infant, resulting in delayed development May lead to stress in relationships Increased risk for future episodes of depression Increased risk of self injury/suicide Difficulty or failure in job performance

11. Perinatal Foundation, Inc. How does Depression Manifest in the Workplace? Decreased productivity Lack of cooperation Excessive fatigue Unexplained aches and pains Safety/Accidents Trouble completing projects or focusing on work Tardiness Absenteeism Alcohol/Drug use Low morale

12. Perinatal Foundation, Inc. Why Is Depression a Business Issue? 200 million lost workdays per year Costs billions of dollars annually Rising healthcare costs Affects people on prime working years

13. Perinatal Foundation, Inc. Business Issue - 2 1/3 of costs for treatment, 2/3 of costs related to absenteeism and lost productivity Cost of untreated vs. treated 8 of 10 HR professionals reported that depression/anxiety has been a problem with their employees for at least 3 years Two of America’s most costly illnesses – similar to the cost of heart disease. Medical, legal, insurance & worker’s comp

14. Perinatal Foundation, Inc. Employee Attitudes Most don’t seek treatment Concerned with confidentiality Fear that seeking treatment will affect job Unsure of health coverage Embarrassed or reluctant to talk Myths – Personal weakness, “tough it out” Stigma

15. Perinatal Foundation, Inc. Impact on People All levels of the corporate ladder Depression or anxiety can affect anyone Career path Lifetime earnings Impact on family, co-workers

16. Perinatal Foundation, Inc. What Can Employers Do? Gain senior management support Educate managers Educate employees Provide resources (specify) Communicate available EAP or other services Get input from employees (about?) Develop a network of partners

17. Perinatal Foundation, Inc. What Can Employers Do? - 2 Encourage mental health screening Add educational pieces to existing meetings Encourage treatment Encourage healthy lifestyles Respond to changes and crises Review medical and employee benefit plans Review relevant company policies

18. Perinatal Foundation, Inc. What Can Employers Do? - 3 Ensure understanding of state/federal law Ensure fairness and consistency Value and respect diversity Provide appropriate work/life balance Commit to creating a culture which supports overall health and well being

19. Perinatal Foundation, Inc. Payoffs Healthcare cost containment Fewer days lost to absenteeism Improved morale and productivity Avoid or minimize most illnesses Reduced turnover

20. Perinatal Foundation, Inc. Summary Motherhood is not magical for women with postpartum depression PPD is common and treatable People recover from depression with the support of their care providers, family, and employers

21. Perinatal Foundation, Inc. Summary – 2 Early identification and treatment saves employers money and prevents needless suffering. Employers can be partners in supporting mental health.

22. Perinatal Foundation, Inc. Contact Information Ann Conway, RN, MS, MPA Executive Director Perinatal Foundation, Inc. McConnell Hall 1010 Mound St. Madison, WI 53715 aeconway@wisc.edu (608) 267-6200 - phone (608) 267-6089 - fax www.perinatalweb.org Cara Hansen Dir. of Community Outreach Mental Health Association in Milwaukee Co. 734 N. 4 th St., Suite 200 Milwaukee, WI 53203 cara@mhamilw.org (414) 276-3122 – phone (414) 276-3124 – fax www.mhamilw.org