Screening for Maternal Depression in Mothers of Young Children: Considerations with Low-Income and Racial/Ethnic Minority Populations

Maternal depression in mothers of infants and young children is a serious problem that can have long term negative consequences for the child and the maternal-child relationship. Many experts advocate universal screening for mothers who have recently given birth, mothers in home visiting programs, or mothers in well baby clinics and other early childhood settings to ensure that those in need of treatment are identified. These recommendations often assume that the particular screening method will be effective with all populations without adaptations for the audience. As social workers, we are cognizant of the disparities that exist for poor and minority communities and the need to adapt protocols to the audience we serve.

The purpose of this roundtable is to create a dialogue among participants about issues that arise in depression screening with low-income and ethnic minority mothers, to share experiences, and create new strategies for effective screening in both research and practice settings. Given that rates of depression are elevated in poor and minority populations, it is essential to ensure that the methods we use to screen for depression are effective at identifying mothers who are depressed to enable development of programs effective in targeting this population.

The presenters in this roundtable are all intervention researchers focusing on maternal and infant mental health who screened for depression as part of their research. Each presenter encountered obstacles in the process relating to their particular population and setting and while they created different strategies, there were commonalities that informed their work. We will begin our roundtable with brief descriptions of our experiences in screening in a perinatal clinic, a home visiting program, and a Head Start program to discuss barriers that arose and the way we addressed the challenges with different populations. These barriers related to stigma, language of screening, instrumentation, trust in the process, attitudes and training of the screeners, and agency factors. We will engage participants in a discussion about their experiences or concerns with screening in underserved communities and share ways to develop effective solutions for the challenges.

Our first presenter will share the process that led to our mutual concerns about depression screening and her experiences with instituting screening in a Head Start program. Our second presenter will discuss her experiences with screening in a perinatal clinic, including differences in reported acceptability of screening among high and low-income mothers and how attitudes of screeners influenced the outcome of the screening. Our third presenter will discuss the ways in which community screeners more effectively addressed stigma compared to clinical providers. Our fourth presenter will discuss her qualitative work with low-income predominantly Latina mothers, highlighting perceptions of the screening process, and unique barriers to acceptability among this population.

Our goal is to use the roundtable forum to increase awareness of screening issues in research and practice. We hope that this ongoing work can promote reduction of ethnic, racial, linguistic, and economic disparities in the access and utilization of mental health services among mothers of young children who are experiencing depression.