development of children. This analysis evaluated the levels of evidence that are needed to show (1) associations between parental depression, parenting practices, and child outcomes and (2) the efficacy of screening, treatment, and prevention strategies and policies on the negative effects of parental depression on children in diverse settings and populations. On the basis of this analysis, the committee then described an ideal vision of a depression care intervention system (Chapter 8), highlighting important components of this system that are emerging in selected service settings as well as through state, federal, and European initiatives. The clues that are emerging from these initiatives also highlight three major barriers associated with implementing these innovative approaches that must be addressed as outlined by the committee (Chapter 9), including a variety of systemic, workforce, and fiscal policies.

Chapter 10 now provides an overview of two separate areas in which next steps can be taken in the design and implementation of the ideal prevention and depression system for parental depression described in Chapter 8 if the systemic, workforce, and fiscal challenges can be overcome. The two areas are (1) developing a research agenda that highlights priorities for new knowledge development and (2) creating policy and learning environments that contribute to successful dissemination and implementation of effective practices for improving the quality of care for depressed parents and their children.

Each area involves diverse and challenging issues that require attention from policy makers, the research community, and program administrators. A common goal is to develop evidence-based programs and collaborative strategies, as well as to create incentives to adopt innovative approaches within learning environments that strive to reach those who are in greatest need and those who are most difficult to serve.


In addition to strengthening the systemic, workforce, and fiscal policy approaches outlined in the previous chapter, the committee outlines a research agenda that builds on four fundamental challenges faced in attempting to address the problem of parental depression: (1) integrating knowledge, (2) applying a developmental framework, (3) conceptualizing the problems as two-generation in nature, and (4) acknowledging the presence of the constellation of risk factors, context, and correlates associated with depression (see Chapter 2). The committee now focuses on specific content areas that represent significant research opportunities.

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