“I will never forget him”

Posted in Development and Learning Disability  |  Tagged , ,

How EI Providers Can Make a Difference For Mothers Experiencing Maternal Depression.

by Minelva Holove, Veronica Val, and Abigail Ernharth (GU CEI ’23)

“What affected me the most was my motivation to follow through with the activities that I was supposed to do with my son at home. I actually remember feeling overwhelmed by the activities whenever I was given a new one and I felt very guilty when I was asked the next time around if I had completed/worked on the homework with my son. Looking back I can see I did the best that I could in that moment in time, but I did feel guilt and shame as a parent since I could not muster the energy or motivation to work on the suggested activities.” –Former EI participant, Personal Communication, May 2023

According to the Centers for Disease Control and Prevention (CDC, 2022) 1 in 8 women experience symptoms of depression after giving birth, 1 in 5 are not asked about depression during prenatal visits, and 50% of mothers with depression go untreated. Research has shown children who have mothers who experienced depression are more likely to develop an array of difficulties such as: developmental delays, feeding problems, and behavioral issues (Boyd, 2016). Additionally, these problems may extend beyond childhood, increasing peer difficulties and the risk of depression and suicide in adulthood (Boyd, 2016). Sontag-Padilla et al., (2013) discussed how maternal depression affects the following care systems: public assistance systems, physical health care system, early intervention system, education system, and the child welfare system. The evidence concludes that maternal depression can have negative financial outcomes for multiple public-sector service systems as it can affect employment/unemployment and income leading to costly public assistance programs. Additionally, maternal depression increases the risk of child maltreatment and of children entering the school system unprepared. Unfortunately, many mothers with depressive symptoms go undiagnosed and/or unidentified.

Alvarez et al., (2015) explore the provision of mental health services to mothers whose children are already participating in EI. The authors discussed how early intervention services for children and services for maternal depression are currently provided through uncoordinated services; however, they bring up advantages should the services be provided through EI. The article stated that while mothers with depressive symptoms may not seek out help through mental health services, they are just as likely as mothers without depressive symptoms to seek out early intervention services for their children. This provides EI with a unique opportunity to offer mental health services for mothers who would have otherwise gone without any assistance. One of the advantages discussed is that EI can provide a nonthreatening avenue for these services due to an already established rapport. Second, it can address mental health from the standpoint of child development, which could possibly reduce the stigma that accompanies mental health issues.

Addressing maternal depression in EI services becomes important not just for the development of the child, but also for the health of the mother. A little can go a long way.

“They sent an OT. I will never forget him. He was very conscientious of me and my son. He also spent time reassuring me and letting me know that I was doing my best. I genuinely felt that he cared for my family and he really wanted to help us”. Former EI participant, personal communication, May 2023.

So What Did EI Do?

When asked what was done by EI to address maternal depression, the former participant stated that not much was done, but she credited the EI OT simple, caring efforts:

  • He invited me into what he was doing
  • He talked through my insecurities and fears
  • He explained procedures and how to seek more help
  • He taught me a lot of the exercises he did and made sure I understood them
  • When he left our home after each session, I felt helped

These steps taken by the therapist seem to fall within the recently adapted coaching style to EI with a primary service provider, indicating that this can be an effective way to address maternal depression.

Resources

There are a variety of resources available to EI service providers to address maternal depression. Some actions can be simple and do not require formal training. The simple empathetic actions of an EI therapist can make a difference in and change the life of a mother.

Early HeadStart programs address maternal depression through five steps:

  1. Identify families in need of support through validated screening tools
  2. Train staff about depression warning signs and how to talk to families
  3. Provide reflective supervision for staff working with families who have mental health challenges
  4. Connect families with community-based treatment services
  5. Promote Awareness: Reduce stigma by promoting awareness of depression as a common treatable condition. These steps can be easily applied to EI’s provision of services.

Mothers and Babies is a program that addresses postpartum depression by providing affordable services to families and conducting research to focus on expanding the program to ensure health equity. The program has developed training modules that can be accessed by various organizations and families to educate themselves on maternal depression and how to address it.

The following DC programs are available to those who may be experiencing depression.

Early Stages: Provides early intervention services for children ages 0 – 3 with developmental delays and disabilities in DC.

DC Healthy Families: Provides free health insurance to DC residents who qualify.

DC Collaborative for Mental Health in Pediatric Primary Care: This program’s goal is to integrate mental health services into primary care in DC.

DC Healthy Start: Provide services, referrals, and support for women, parents, and infants up to 18 months of age in wards 5, 7, and 8 in the District of Columbia.

References

Alvarez, S., Meltzer-Brody, S., Mandel, M., & Beeber, L. (2015). Maternal depression and early intervention: A call for an integration of services. Infants Young Child, 28 (1): 72-87. doi:10.1097/IYC.0000000000000024.

Boyd, R. (2016). Expanding early intervention services to address postpartum depression.

Children’s Hospital of Philadelphia: Police Lab. https://policylab.chop.edu/blog/expanding-early-intervention-services-address-postpartu m-depression

Centers for Disease Control & Prevention (CDC). (2022). Identifying Maternal Depression.https://www.cdc.gov/reproductivehealth/vital-signs/identifying-maternal-depr ession/index.html

Milgrom, J., & Holt, C. (2014). Early intervention to protect the mother-infant relationship following postnatal depression: Study protocol for a randomized controlled trial. BioMed Central, 15 (1): 385. http://www.trialsjournal.com/content/15/1/385

Sontag-Padilla, L., Schultz, D., Reynolds, K. A., Lovejoy, S. L., & Firth, R. (2013). Maternal Depression: Implications for Systems Serving Mother and Child. In Maternal Depression: Implications for Systems Serving Mother and Child; pp. 1–9. RAND Corporation. http://www.jstor.org/stable/10.7249/j.ctt5hhtwv.1