Coordinated assessment and care for all family members is warranted: report
WEDNESDAY, June 10 (HealthDay News) -- When parents are depressed, their children can suffer too.
A new report from the National Research Council and the Institute of Medicine calls for health and social service professionals to pay greater attention to the impact of parental depression on their children.
Rather than treating only the depressed adult, health-care and mental-health professionals should evaluate the fallout of the depression on the entire family, particularly children, and design treatment programs with everyone in mind, according to the report that was to be released Wednesday.
Since most depression counseling and treatment programs are designed to deal only with the depressed individual, federal and state agencies, nonprofit organizations and private-sector providers should work to find nontraditional ways of helping the whole family, the report says.
"To break the vicious circle of depression, we need to refocus our view of this illness through a broader lens that sees the whole family, not just the individual with depression," said committee chair and psychiatrist Mary Jane England, president of Regis College in Weston, Mass. "Our report describes a new vision for depression care that would provide comprehensive services not just to adults, but to their children as well. It will take significant policy changes to make this vision a reality, but the benefits warrant the effort."
About one in five U.S. parents experience depression annually. About 15.6 million children under 18 live with an adult who has had major depression in the past year, the report noted.
While depressed parents don't necessarily harm their children -- deliberately or inadvertently -- studies have shown parental depression can increase the chances of children having health, emotional and behavioral problems.
Yet, even if health-care professionals come up with creative ways to include all family members in the treatment plan, obstacles remain. Only one-third of adult sufferers seek treatment for their depression, which means their children probably won't get treatment either.
Removing barriers to coordinating care across agencies and service providers, asking patients with depression if they have children and if their depression affects family members and requiring health plans to cover a greater range of mental-health services would help put the focus on the family, according to the report.
In addition, making affordable depression treatment available outside of traditional doctor's offices may encourage people to make use of the services. Suggested locations include Head Start facilities, schools, prisons, other community locations and people's homes.
The report also called on states to revise regulations that prohibit services from being offered outside of clinical settings, and urged federal agencies to establish a national program to improve the ability of primary-care providers, mental-health and substance-abuse professionals to treat depression and lessen its effects on children.
To help protect children from the negative impact of parental depression, the report suggested that Centers for Medicare & Medicaid Services (CMS) extend Medicaid services for new mothers to two years after birth, a critical period of development.
CMS could reimburse primary-care providers for mental-health services and cover preventive services for children at risk of developing problems, rather than cover treatment only after problems occur.
The study was sponsored by the Robert Wood Johnson Foundation, Annie E. Casey Foundation, California Endowment, U.S. Health Resources and Services Administration and Substance Abuse and Mental Health Services Administration.
More informationThe U.S. National Institute of Mental Health has more on depression.
-- Jennifer Thomas
SOURCE: U.S. National Academy of Sciences, news release, June 10, 2009
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