Despite Increases in Screening, Study Finds Only 44 Percent of Pediatricians Inquire about Maternal Depression
NEW YORK (February 29, 2016) – Although askingabout maternal depression increased among pediatricians by
about 30 percent between 2004 and 2013, less than half of pediatricians usually screen for the condition. According to
researchers from the Children’s Hospital at Montefiore (CHAM),NYU Langone Medical
Center and the Nathan Kline Institute for Psychiatric Research, this represents a missed opportunity to identify depression
and provide women appropriate treatment. The findings of this study are in the current issue of the Journal of Developmental & Behavioral Pediatrics.
Maternal depression affectsup to 40 percent of mothers with young childrenand can havemany negative effects on the infant
and developing child including feeding issues,the ability to thrive in relationships and poor cognitive health.
“Maternal depression is often overlooked and untreated because women with mental health issues donot routinely access health
care for themselves,” said Ruth E. K. Stein, M.D., co-author, attending physician, CHAM and professor of Pediatrics,
Albert Einstein College of Medicine. “The pediatrician’s office is a frequently-visited venue for mothers, offering invaluable
opportunities for pediatricians to identify the condition and connect moms with services that can help families thrive.”
Researchers analyzed data fromthe American Academy of Pediatrics Periodic Surveys. The most recent survey included 321 non-trainee,
general practice pediatricians who answered questions about maternal mental health, access to services and training in
mental health in 2013. Survey results were compared to a similar sample (457 pediatricians) who answered the same questions
in 2004.Between 2004 and 2013 the percentage of pediatricians who usually asked about maternal depression increased from
33 to 44 percent.
The US Task Force for Preventive Services recently released updated guidelines specifically recommending screening for depression in pregnant and postpartum
women.
“Our study demonstrates that screening by pediatricians has increased over the years, which is promising,” said Bonnie D.
Kerker, PhD., lead author, associate professor, Department of Child and Adolescent Psychiatry, NYU Langone Medical Center’s
Child Study Center, and Research Scientist, Nathan Kline Institute. “Not all pediatricians, however,think mental health
or family health is within the scope of their practice. Given how much we know about parent characteristics as risk factors
for poor child development, we need to place more emphasis on understanding the entire family context, so pediatricians
can provide appropriate care for their patients.”
The researchers believe there are several barriers to screening and implementing services for families,including reimbursement
policies that differ from state to state and which may not cover time spent talking to patients’ mothers about their
mental health. Onsite, evidence-based screening and interventions for maternal depression are also not always accessible,
promptingoff-site referrals, which make it less likely that families get the treatment they need.
“Providers may be hesitant to screen if they don’t have feasible treatment options to offer their patients,” said Dr. Kerker.
“While some women may need intensive mental health treatment, others may have mild symptoms that, if left untreated,
could become more serious. Offering low-cost preventive interventions that can be implemented by broader teams of mental
health providers could reduce symptoms and prevent severe depression among at-risk women.”
The study authors also believe that training the next generation of physicians in the importance of family health to children’s
well-being would greatly benefit children and their families.
At Montefiore Health System robust efforts have been underway for more than a decade to integrate behavioral health services in pediatric primary care. Pediatricians, psychologists, psychiatrists
and social workers collaborate closely to conduct preventive screenings, assessments, counseling, and interventions to
improve outcomes for children and their caregivers.
About Montefiore Health System
Montefiore Health System is a premier academic health system and the University Hospital for Albert Einstein College
of Medicine. Combining nationally-recognized clinical excellence with a population health perspective that focuses on
the comprehensive needs of the communities it serves, Montefiore delivers coordinated, compassionate, science-driven
care where, when and how patients need it most. Montefiore consists of eight hospitals and an extended care facility
with a total of 2,747 beds, a School of Nursing, and state-of-the-art primary and specialty care provided through a network
of more than 150 locations across the region, including the largest school health program in the nation and a home health
program. The Children's Hospital at Montefiore is consistently named in U.S. News'
"America's Best Children's Hospitals." Montefiore's partnership with Einstein advances clinical and translational research
to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. The health
system derives its inspiration for excellence from its patients and community, and continues to be on the frontlines
of developing innovative approaches to care. For more information please visit http://www.montefiore.org.
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