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Tackling Depression Among Low-Income Mothers Can Help Children

About 9 percent of low-income mothers with young kids suffered from severe depression during the past year and more than one-third of them did not receive treatment for a variety of reasons.

That statistic is sobering when we consider that living with such a condition can pose risks for the mother and to the safety, learning, and development of her children. It also raises the likelihood that the kids will be abused or neglected by a mother who's unable to cope.

The good news is that the condition is highly treatable. Studies show that many of the afflicted women are connected to social services, which could provide a conduit to treatment. And since low-income women are significantly less likely to receive treatment if they don't have insurance, increased access to Medicaid starting in 2014 under the Affordable Care Act could create more opportunities for treatment.

So there's a "promising opportunity" to make a difference in the lives of these women through changes to public policy and social services. That was the take-home message from a panel discussion about maternal depression as a public health issue held Thursday at the Urban Institute in Washington, D.C. Panelists represented the Urban Institute, the U.S. Department of Health and Human Services, and Georgetown University's Center for Child and Human Development.

"Treatment for the mother is often prevention for the child," noted Larke Huang, a senior adviser for the Health and Human Service's Department's Office of Policy Planning and Innovation, and the director of its Office of Behavioral Health Equity, Substance Abuse, and Mental Health Services Administration.

According to studies by the Urban Institute, 8.8 percent of low-income mothers of infants to kids age 5 have suffered a major depressive episode severe enough to interfere with daily function and lasting two weeks or more in the past year. "That's 750,000 women," noted Marla McDaniel, senior research associate for the Institute's Center on Labor, Human Services, and Population.

So the question is how to make sure these women can get access to treatment to suit their needs, according to the panelists. Coordinating screening through such federal programs as Women, Infants and Children, which provides funding for food and nutrition services and touches 50 percent of all children born in the U.S., is one way to tackle the problem, panelists said.

But Huang noted that efforts to coordinate services across federal agencies can be stymied because each agency has its own mandate and "we can't always use resources the way we want to."

And then there's the lack of insurance and access to services, which pose obstacles for helping low-income women. The persistent stigma and myths attached to metal health issues are also "huge barriers," according to Deborah Perry, an associate professor at Georgetown's Center for Child and Human Development.

Some of those myths include a fear among some low-income women about being deported if they seek help or that social services will take their children away, Perry said.

"The myths and stigma are getting in the way of the work that we need to do," she said.

Still, panelists see a way forward with current efforts to coordinate federal policies and practices, provide women with support networks within their own communities, and integrate screening for behavioral health into primary care.

More work also needs to be done on finding ways to prevent the development of depression and making sure that those women who are diagnosed receive the best type of treatment—whether that's therapy, medication, or a combination of the two, panelists said.


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