Problem-Solving Education, a parent component to the Head Start program, showed a potential approach to provide referral support and improve depressive symptoms in young mothers, according to a publication in Psychiatric Services.
Researchers in this randomized study evaluated the effects of the Problem-Solving Education program on reducing depressive symptoms and increasing engagement with mental health services for mothers with young children. The control arm (n=119) included usual services provided by Head Start, such as family needs assessments, assistance with food, job, or housing resources, parenting groups, and referrals to behavioral health services. The experimental arm (n=111) included Problem-Solving Education with 6 sessions of problem-solving instruction with certified intervention providers, depressive symptom monitoring, and connections to mental health services. Data collection occurred at baseline and every 2 months for a year and included information on depression, anxiety, and post-traumatic stress disorder and mental health care utilization.
At baseline, the mothers in the Problem-Solving Education arm had a mean depressive symptom score of 8.11 (SD±5.20), 17% had previously utilized specialty care mental health services, and 18% had previously utilized primary care mental health services. Of the participants in this arm, 59% completed all session of the Problem-Solving Education. At month 2, 10% of the mothers utilized a mental health service referral, and by month 12, 21% utilized a mental health service referral. For this arm, there was a significant treatment by time interaction (P =.016). For mothers with persistent depressive symptoms, by month 2, 12% sought out specialized mental health care, and by month 12, 46% sought out specialized mental health care. This subgroup population had a significant treatment by time interaction (P =.029).
At baseline, the mothers in the usual services are had a mean depressive symptom score of 7.59 (SD±4.38), 24% had previously utilized specialty care mental health services, and 12% had previously utilized primary care mental health services. For this arm, there was no increase in mental health care service utilization. For mothers with persistent depressive symptoms, there was a 9% increase in the use of specialized mental health care from month 2 to month 12.
Future studies need to increase sample sizes of subgroup categories to draw more widespread conclusions, analyze different local resources and insurance carries for access to mental health services, and measure retention of the specialized mental health care services.
The study researchers concluded that Problem-Solving Education can promote mental health care among young mothers by encouraging the utilization of specialized mental health care services.
Silverstein M, Diaz-Linhart Y, Cabral H, et al. Engaging mothers with depressive symptoms in care: results of a randomized controlled trial in Head Start [published online September 26, 2018]. Psychiatr Serv. doi: 10.1176/appi.ps.201800173