Initiative to help families face the challenges of parental depression and early childhood developmental delays

A Pittsburgh-based maternal and child health care collaborative will undertake a unique and innovative initiative to help families face the challenges of parental depression and early childhood developmental delays.

Under U.S. federal law, all states must implement a system of early intervention services for infants and toddlers, birth to age three, who have developmental concerns, and their families. Many states do not include risk factors in their eligibility criteria. This is unfortunate as parental depression is widely recognized as a potential risk factor for affecting a child's development. Through this initiative, young children in families where parental depression may exist will be tracked for developmental delays within the Allegheny County early intervention system.

The Helping Families Raise Healthy Children initiative is supported by a three-year, $500,000 matching grant from the Robert Wood Johnson Foundation Local Funding Partnerships program. The grant was awarded to Community Care, the managed behavioral health care organization in Allegheny County. Local funders of the initiative currently include The Highmark Foundation (nominating funder), UPMC Health Plan, The Pittsburgh Foundation, The Fine Foundation, FISA Foundation, and Jewish Healthcare Foundation.

"Studies have shown that parents who are depressed lack the energy to carry out consistent routines and to engage in the early bonding and attachment process that is critical to health and development in early childhood," said Diane P. Holder, president and chief executive officer of UPMC Health Plan.

"At the same time, a child's developmental delays can negatively impact parental stress and depression. This project can build a new pathway to care for these dual-risk families," she said.

Community Care is partnering with the Alliance for Infants and Toddlers - which coordinates early intervention services for families in Allegheny County - and the RAND-University of Pittsburgh Health Institute, a nonprofit organization which will provide training, technical assistance, and evaluation support for the initiative.

Helping Families Raise Healthy Children is working to improve the way local systems of care work so that more families facing the challenges of parental depression and early childhood developmental delays receive the supports and services they need to live healthier lives. The initiative focuses primarily on low-income families in Allegheny County. The collaborative includes the four local Medicaid managed care organizations and over 30 organizations representing physical and behavioral health providers, early intervention specialists, and community maternal and child health staff.

"The Highmark Foundation supported Helping Families Raise Healthy Children because of significant opportunities to improve the health of families in this region," said Yvonne Cook, president of The Highmark Foundation. "This is also an important issue for other local funders that have a vested interest in the health of our communities."

Local funders have been supporting the work of the collaborative since 2002. Early on, the collaborative identified depression as a high priority local public health issue. While efforts are underway to enhance identification and treatment of women at high risk for maternal depression within the maternal and child health care system, many caregivers with depression remain unidentified and untreated. In addition, an estimated 40 percent of the 2,500 infants and toddlers who are referred each year to early intervention due to medical and/or environmental risks have primary caregivers with depression.

"The proposed initiative will help us to better serve families by screening for parental depression in the early intervention system and engaging at-risk parents and their very young children in appropriate care that meets their needs and preferences," said James Gavin, president of Community Care.

"What's important about this initiative is that it looks at the family as a unit," said Melanie Hallums, family liaison for the initiative. "Now, both the caregiver and the child will receive the attention they need."

"Getting help to caregivers who may suffer from depression is not always easy. Many of these parents are overwhelmed by their young children's needs, as well as other daily life challenges, and are not aware of, cannot get to, or do not feel comfortable accessing available behavioral health services," said Michele Myers-Cepicka, executive director of the Alliance for Infants and Toddlers. Building trust between caregivers and service providers will be a primary focus of the initiative.

"Despite the well-established connections between parental depression and early childhood development, our local systems of care are set up to serve children at risk for developmental delays and parents at risk for depression as if the conditions and patient groups are independent of each other," said Donna Keyser, management scientist at the RAND Corporation and project director for Helping Families Raise Healthy Children. "This initiative will bridge these gaps by strengthening relationships among providers in the maternal and child health care system and the early intervention system, and training both groups to provide culturally competent, family-centered care."

The Local Funding Partnerships (LFP) program is one of the most competitive annual grant-making programs of the Robert Wood Johnson Foundation. In 2009, the LFP program received 127 applications; only 11 projects were awarded funding.

To introduce this initiative to the community, the collaborative will host a kick-off celebration for its partners and their families on Nov. 6, 2009, at 6 p.m. at The Children's Museum of Pittsburgh.