New ways to treat maternal depression
The Herald-Tribune - 11/4/2018
Nov. 04--Mothering might be the most demanding and meaningful job on the planet.
That's why a mother's mental health is a major factor in making sure she can be the caregiver her baby needs.
But for many, getting help can be because of stigma, a lack of insurance coverage or other causes.
That's why MOMS meetings happen in grocery stores, libraries and community centers free of cost.
The clinicians from the national program, Mental Health Outreach for Mothers, applied what they learned from the mothers they interviewed first-hand.
"The program was borne out of failure. We screened for maternal depression but weren't able to change outcomes because they weren't engaging in mental health care," said Dr. Megan Smith, associate professor at the Yale School of Medicine and director of MOMS.
The idea came to Smith after a mom told her grocery shopping is one of the only places where she gets to enjoy some alone time. The change of venue lifts the stigma of having moms go to a specialized clinic. It's also familiar.
Mom "ambassadors" from the community are part of the team delivering care, offering an empathetic person to help alleviate intimidation and, sometimes, distrust.
While Smith said maternal depression is well distributed overall, white women use mental health services at more than twice the rate of black or Hispanic women, according to the federal Substance Abuse and Mental Health Services Administration.
"There is at times a lack of cultural understanding by doctors and discrepancies in language," she said.
The stigma surrounding mental health issues can also create fear of child removal.
So far more than 3,000 women have been helped through the program, but MOMS aims to at least triple that number over the next ten years.
Smith said between 20-30 percent of mothers meet criteria for a diagnosable depressive disorder. And there are far more women, 40-60 percent, who have depressive symptoms that can affect basic functions like appetite and sleep.
Financially it becomes difficult to maintain a job or go to school and in the most severe cases, may lead to thoughts of suicide and self harm.
But maternal depression isn't exclusively about mom. For many children, an untreated mother is one of their earliest adverse childhood experiences (ACE).
Gone ignored, it can rob children of the emotionally nourishing mother-child relationship they rely on for healthy development.
"Mothers with depressive symptoms have difficulty engaging with their children. They may not sing, read or play with them. It's a challenge to pack a lunch. There's a loss of joy and hope," Smith said.
MOMS applies the latest brain science that accounts for brain plasticity in both adults and children -- the ability to change and heal with the appropriate interventions.
"We know that with high quality treatment for depression, mothers get better and children do better. We know when mothers are mentally healthy, children are too. That's why we need to make mental health care more available, affordable and accessible," Smith said.
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