"I felt like I was always overwhelmed and often sad. I was irritable with my children and husband and felt like I was never a good enough parent. I didn't know a way out. I appreciated the help from my pediatrician."—A mother in one of the Parental Well-Being Project's practices
This mother's description of her experience with depression—and of the role her child's pediatrician played—remind us that pediatric health providers can help parents and children by screening for parental depression. After all, the pediatrician is often the health care provider who has the most contact with parents during the childhood years. Yet, for pediatric health providers to be truly effective in detecting and intervening in parental depression during well-child office visits, systematic screening methods are needed.
With the support of The Commonwealth Fund, the Dartmouth Parental Well-Being Project has created a realistic way for pediatric health providers to routinely screen for parental depression and refer parents for help. Through our practice-based research network, we have developed and tested practical approaches that can be implemented at well-child visits. While 90 percent of the contacts were with mothers, this approach was also used when fathers attended the visit without mothers.
This manual and its support materials are based on our experience with screening more than 9,000 parents in six different pediatric primary care practices over six months. The manual is divided into four sections: a summary of the Well-Being Project; a review of the role of the pediatric provider in the screening process; the five steps for implementing screening in pediatric practices; and a guide for the practice's parent organization or an outside organization or agency, such as a practice network, to assist primary care practices in designing and implementing parental depression screening.
These materials are intended to be used:
- by individual providers seeking to improve how they recognize and assist depressed parents—these tools can be used by health providers in a variety of settings;
- by primary care practices seeking to make practice-level change in how they meet the needs of depressed parents and their vulnerable children; and
- by external organizations seeking to change primary care detection of maternal or paternal depression in multiple practices. This includes health departments, learning collaborative organizations, health plans, and other social service agencies.
The Parental Well-Being Project staff are available to consult on the implementation of any aspect of this project.