FEDERAL-LEVEL INITIATIVES

Federal efforts in the United States to treat and prevent depression among parents and to mitigate the effects of a parent’s depression on children currently include data collection; health education; treatment, prevention, and workforce development; and research activities. These activities, currently scattered across several agencies in the U.S. Department of Health and Human Services, provide a basis for the development of more intensive and collaborative programs and policies to enhance state-based and professional responses to depression in parents and early interventions for children whose parents may be affected by this disorder. At present, federal efforts focus primarily on maternal depression that occurs during pregnancy or the postpartum period. Although one of the strategic goals of the U.S. Department of Health and Human Services is to “promote and encourage preventative health care, including mental health, lifelong healthy behaviors, and recovery” (U.S. Department of Health and Human Services, n.d.), efforts to coordinate programmatic, policy, and research efforts targeted to depression in parents have not emerged as a national priority.

Agency for Healthcare Research and Quality

A 2005 report for the Agency for Healthcare Research and Quality (AHRQ), Perinatal Depression: Prevalence, Screening, Accuracy, and Screening Outcomes (Gaynes et al., 2005), observed that depression is as common in women during pregnancy as it is after they give birth. The report defined perinatal depression as a condition that encompasses major and minor depressive episodes that occur either during pregnancy or within the first 12 months after delivery, noting that this disorder may affect as many as 5 to 25 percent of new mothers. The AHRQ report indicates that these repercussions are of significant public health concern and concludes that perinatal depression is the leading cause of disease-related disability among women, resulting in depressive episodes and negatively affecting their children and families.

To assist health care providers and community planners, AHRQ has also developed a guide to adopting innovations that provides generic advice on the issues and steps that potential adopters should consider and whether or not a given innovation will address their needs and is feasible (Brach et al., 2008). Further details of this report are provided in Chapter 10.

Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) initiated the Pregnancy Risk Assessment Monitoring System (PRAMS) in 1987. The



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