Depression among caregivers who bring their children to community mental health clinics for disruptive behavior disorders

Background and Purpose: Parents who bring their children to mental health treatment frequently manifest high rates of mental health difficulties (Ferro et al., 2000; Swartz et al., 2005; Rishel et al., 2006). At the same time, many of these parents do not receive mental health services (i.e., Ferro et al., 2000; Swartz et al., 2005). Untreated parental depression, in particular, can have deleterious consequences for child mental health (e.g., Downey & Coyne, 1990). Little research has examined rates of caregiver depression among urban families where children receive treatment for disruptive behavior disorders. Consequently, this study answers the following questions: (1) What are the rates of caregiver depression among those parents bringing their children to treatment for disruptive behavior disorders? (2) Among those caregivers with clinically significant levels of depression, what percentage report ever receiving mental health treatment?

Methods: This study utilized baseline data from the Family Groups for Urban Youth with Disruptive Behaviors study, currently in its 3rd year of 5-year NIMH funding. Data were collected from face-to-face interviews with children and caregivers. Children, aged 7-11 who met diagnostic criteria for Oppositional Defiant Disorder or Conduct Disorder, and their caregivers were recruited from urban child mental health clinics. Preliminary baseline data from n=111 caregivers were utilized in the current study. Caregiver depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977). Caregiver mental health service use was assessed by asking whether caregivers had ever been to parent counseling or therapy, family therapy, and any type of mental health treatment (e.g., outpatient therapy, medication management, substance abuse treatment, inpatient hospitalization, day treatment, residential treatment, case management, evaluation). Descriptive analyses determined rates of clinically significant caregiver depression (scoring >=16 on CES-D) and lifetime mental health service use.

Results: Findings indicate that 57% (n = 63) of caregivers reported manifesting clinically significant levels of depression. This is substantially higher than national rates, which indicate 1.5% to 6.7% of U.S. adults suffer from a depressive disorder (Kessler et al., 2005). Among those caregivers manifesting clinically significant levels of depression, 22% (n = 14) reported ever receiving parent counseling or therapy, 30% (n = 19) reported ever receiving family therapy, and 40% (n = 25) reported ever receiving any type of mental health service.

Conclusions and Implications: Findings are consistent with prior research indicating caregivers who bring their children to psychiatric treatment manifest substantially higher levels of mental health difficulties than adults in the general population. At the same time, results suggest that only a minority of caregivers manifesting clinically significant levels of depression report ever receiving mental health services. These findings are concerning, given the deleterious effect that untreated caregiver depression can have on child mental health. Findings suggest that greater attention should be paid to identifying caregiver depression among children receiving psychiatric treatment, as well as ensuring that parents with mental health difficulties receive appropriate treatment.