routine pregnancy and postpartum clinical visits and other child health visits. These approaches provide opportunities to identify individuals who are at a higher risk for depression, provide education and support, assess parental function, and link child development screening with maternal depression screening.

Other Settings

  • Studies have examined screening for depression in parents—particularly mothers—in existing community programs (e.g., early Head Start, those serving homeless women, substance use disorder treatment, home visitation), where individuals who are at higher risk of depression are seen. Although these settings and programs offer opportunities to reach parents and their children at greater risk for depression, screening is not routine.

Implementation

  • Little information is available in either public or private settings about the complex process of implementing a systematic approach to maternal or paternal depression screening and follow-up, including time, resources needed, workforce and training competency and capacity, and the impact of engagement and education of depressed parents on the parents as well as their children.

This chapter addresses screening parents for depression in primary care and other health and community programs. First, the evidence basis for screening adults for depression and the use of brief clinical screening tools is discussed. Next, this chapter discusses the current research on parental depression screening at both maternal postpartum and well-child visits. When available, the discussion includes comparison to other informal and diagnostic approaches to the assessment of depression in these settings. Because successful screening and intervention involve a systematic approach, rather than only a questionnaire, the chapter discusses the challenges in implementation of screening with attention to parental, health provider, and health care system issues. Screening is the initial step in a systematic approach to detection and treating parents with depression. Finally, we consider promising approaches to parental depression screening and assessment in public health settings and with high-risk populations served by homeless, home visitation and substance use programs.

In addressing the impact that depression has on children, the com-



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