Maternal depression in home visitation: A systematic review

Abstract

Depression is prevalent in new mothers and has been shown to have profound negative impacts on parenting, maternal life course, and child development. High rates of maternal depression have been found in home visitation, a widely disseminated prevention approach for high risk mothers and their children. This paper reviews the emerging literature on the prevalence, impact, and treatment of depression in the context of home visitation. Findings are synthesized and methodological and design limitations are considered in interpretation of results. Promising approaches to addressing maternal depression and supporting home visitors in working with this clinical population are described. Recommendations for research and practice are offered that build upon the strong foundation of current efforts in this area.

Limiting Home Visiting Effects: Maternal Depression as a Moderator of Child Maltreatment

“…22,39 Although some studies suggest that HV can reduce maternal depression, 57 and that it is a promising intervention for reaching depressed parents who might not otherwise gain access to the help they need, 44 the results of large-scale evaluations generally indicate that parental depression is a serious impediment to HV program effectiveness. 21 Our study findings also revealed an association between maternal depression and child maltreatment, though the relation differed for mothers who received HV comparedwith mothersinthe control group. Among nondepressed mothers, when controlling for maternal race and age at first birth, those in the HV program were less likely than those in the control group to have a child with a CPS report.…”

“…39,42 On the other hand, maternal depression, common among young mothers and a risk factor for maltreatment, may impede the ability of programs to reduce child abuse and neglect. 21,22,36,[43][44][45] Maternal depression increases the risk for parenting difficulties and is strongly associatedwithchildmaltreatment. 15,[46][47][48][49][50] Of parents investigated by CPS whose children remain in their custody, an estimated 25% report having experienced major depression within the past year.…”

“…13 Home visitation is a broadly implemented service strategy aimed at preventing child abuse and neglect. [21][22][23][24] Although there are differences among models, most endorse the idea that supporting parents will improve the safety and well-being of their children. Home visitation typically offers parents regular, one-on-one visits during which home visitors provide information (eg, regarding infant nutrition, home safety), psychoeducational training (eg, to build childrearing skills and positive parentchild relationships, maintain maternal health), referrals, and case management services related to parenting.…”

Early skill formation and the efficiency of parental investment: A randomized controlled trial of home visiting

“…The average high treatment participant began engaging with the program half way into her pregnancy and had received, on average, 27 home visits between program entry and 18 months. It is possible that this small window of intervention did not allow enough time for the participants to adopt the strategies advised by their mentors as the bond between mentor and participant was still forming (Ammerman et al 2010).…”

Enhancing Home Visiting With Mental Health Consultation

“…3 These child risk factors may arise from dynamics in their own families, including maternal depression and clinical and social correlates of this depression: trauma and intimate partner violence, poor birth outcomes, and infant mortality. 4 Maternal depression, often underdiagnosed and untreated in the first several years of life, is a particularly prevalent concern, with estimates ranging from 15% in the general population to double that in low-income mothers. 5 As pediatric providers begin to incorporate the latest findings from neuroscience into their efforts to establish high-quality medical homes for their patients, they find themselves serving many families who may be at risk for toxic stress and who are experiencing psychosocial challenges.…”