Summary: A new online manual, based on the experiences of Dartmouth Medical School's Parental Well-Being Project, helps pediatric clinicians successfully screen parents for depression, discuss with them the impact depression can have on their children, and refer parents for counseling.
The Issue: Rates of major depression peak during women's childbearing years. Research has shown that maternal and paternal depression can affect parenting behaviors and, ultimately, harm children's health and development. Because pediatricians have frequent contact with parents, they have opportunities to screen for depression and intervene when necessary. Accumulating data about the adverse effect of parental depression on child health, development, and behavior have provided an impetus among pediatric practices for changing clinical care.
Target Audience: Individual pediatric providers; primary care practices; health systems and practice networks; and external quality review organizations seeking to improve primary care detection of parental depression.
The Intervention: The Dartmouth Parental Well-Being Project manual helps pediatric health providers conduct routine screening for parental depression and refer parents to counseling services. The practical approaches developed were tested over a six-month period with more than 9,000 parents in six practices.
The manual is divided into four sections: 1) a summary of the Well-Being Project; 2) a review of the role of the pediatric provider in the screening process; 3) five steps for implementing screening in pediatric practices; and 4) a guide to help the practice's parent organization (or an outside organization or agency, such as a practice network) assist primary care practices in designing and implementing parental depression screening.
For example, "Section Three: Implementation Guide for Depression Screening at the Practice Level," explains how a practice can begin instituting the screening process by engaging all staff members. The section then discusses how clinicians determine who and when to screen, which tools to use, and what community resources are available to parents who need them. There is also guidance on assigning office staff to the new roles they will need to carry out and on providing staff training. Worksheets throughout the manual can be downloaded to support the process.