of depressed parents. These agencies should pay particular attention to groups and populations that have historically and currently experience barriers in receiving quality health care, including for behavioral health. Efforts should be made to ensure that effective strategies are employed to increase the participation and engagement of these vulnerable populations in critical research studies and clinical trials. New research methods and innovative models that partner with vulnerable communities should be supported. Particular focus should be directed at prevention and early intervention efforts that are community based and culturally appropriate so that the high burden of disability currently associated with depression in populations experiencing health disparities can be reduced.

To implement this recommendation, first, the Secretary of the U.S. Department of Health and Human Services should encourage individual agencies, particularly the National Institute of Mental Health, HRSA, CDC, and AHRQ, to identify the parental status of adults and add reliable and valid measures of depression to ongoing longitudinal and cross-sectional studies of parents and children and national health surveys, in ways that will support analyses of prevalence, incidence, disparities, causes, and consequences. Second, CDC should develop guidelines to assist the states in their efforts to collect data on the incidence and prevalence of the number of depressed adults who are parents and the number of children at risk to adverse health and psychological outcomes. Finally, using this information, the U.S. Department of Health and Human Services should encourage agencies, most notably HRSA, to develop a series of public education activities and materials highlighting what is known about the impact of depression in parents. These activities and materials should specifically target the public and individuals who make decisions about care for a diverse population of depressed parents and their children in a variety of settings (e.g., state and county leadership, state health directors, state mental health agencies, and state maternal and child health services).