to improve when screening is accompanied by education and initiation of treatment. Most adult screening studies assess only changes in depressive symptoms and provide little information about patient or system variables that influence treatment choices or effectiveness. However, these screening studies do not inquire about parental status, do not examine how depression affects areas of functioning as a parent, and do not inquire about comorbid conditions (e.g., anxiety and substance use disorders). Rarely are screening programs integrated with service delivery. Mothers with elevated depressive symptoms as well as cases of clinical depression have been successfully identified primarily through screening programs in perinatal health care settings and, to a limited extent, in other private and public primary care settings. Depression in fathers has not been the focus of screening programs. Some programs providing early childhood services to high-risk populations have conducted screening and offer an opportunity to screen parents for depression and parenting function.

Despite the promise of screening programs, current approaches to parental depression screening have not been integrated with assessment of parental function or child development. As national initiatives by organizations and state agencies proceed to promote routine developmental and behavioral screening of young children, it is important to recognize that developmental or behavioral problems in this age group may be related to parenting difficulties and depression and should be assessed.

Furthermore, a number of barriers exist in implementing a comprehensive screening program. For screening to be effective, the paths to further care must be clear and accessible for both the providers who identify the depression and the families so that available clinical and community resources to address issues are used. Limited or poorly organized community resources, or lack of knowledge of existing resources, may decrease willingness to screen.

Linking depression screening to existing screening efforts—such as pre-natal assessment during pregnancy and child developmental screening, at entry into programs serving high-risk parents (e.g., home visiting, homeless, and substance use programs), and other existing treatment or prevention programs—is a first step that could address depression in parents and its impact on their families.

REFERENCES

Abidin, R. (1995). Parenting Stress Index: Professional Manual (2nd ed.). Lutz, FL: Psychological Assessment Resources.

Amaro, H., McGraw, S., Larson, M.J., Lopez, L., Nieves, R., and Marshall, B. (2005). Boston Consortium of Services for Families in Recovery: A trauma-informed intervention model for women’s alcohol and drug addiction treatment. Alcoholism Treatment Quarterly, 22, 95–119.



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