• Existing service programs for families, such as early childhood education and home visitation, often provide preventive services that focus more broadly on parenting and child development. These service programs often serve a large number of depressed parents. Although these programs offer opportunities to identify depression in parents and to integrate treatment and prevention services, few programs routinely do so.

Prevention for Vulnerable Families

  • Some prevention programs targeted to families with depression have been shown to be effective in low-income families and in families from varied cultural and linguistic backgrounds. There is less evidence on the effectiveness of these programs in families with co-occurring conditions such as exposure to trauma and co-existing mental and substance abuse disorders.

  • A variety of existing service programs serve vulnerable families, such as social welfare programs and substance abuse services. Although these programs offer opportunities to identify depression in parents and to integrate treatment and prevention services, few programs routinely do so.

As described in this report, major depression is a highly prevalent disorder among adults of parenting age, and, as a consequence, millions of children in the United States are exposed every year to the risk associated with depression in a parent. Even more children are exposed to heightened levels of depressive symptoms in parents who do not meet diagnostic criteria; these children have also been demonstrated to be at increased risk. So far we have focused on identifying and treating depression in parents. This chapter focuses on efforts to prevent the effects that depression in parents can have on their families, as described in Chapter 4. The importance of preventive efforts is underscored by the scope of the problem and by the high percentage of adult depression, including parents, that goes untreated. Treating parental depression, attending to children’s needs, and assisting parenting are all necessary components to foster resilience, promote health, and prevent disorder in families in which parents are depressed.

An important framework exists for understanding the available literature. The National Academies recently published a report on the prevention of mental, emotional, and behavioral disorders among young people (National Research Council and Institute of Medicine, 2009). The committee strongly supports the overall perspective on prevention presented in



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