Transforming Systems for Parental Depression and Early Childhood Developmental Delays

Many families experience the often co-occurring challenges of parental depression and early childhood developmental delays. The Helping Families Raise Healthy Children initiative, implemented in Allegheny County, Pennsylvania, addressed these challenges by mobilizing and aligning the early intervention and behavioral health systems. The initiative focused on three components of service delivery: (1) screening and identification of families at risk for parental depression, (2) referrals for those identified as being at risk, and (3) engagement in relationship-based services provided by both the early intervention and behavioral health systems that addressed the needs of parents and young children in a parent-child relationship context. More than 4,000 caregivers (primarily mothers) received formal screening for depression through the initiative, representing a screening rate of 63 percent. In addition to formal screening, some self-identified or were identified by community partners as being at risk for depression. In total, nearly 700 caregivers at risk for depression were identified. Among these, the referral rate was 62 percent; 71 percent of those referred engaged in services. These high rates of referral and engagement likely reflect several important components of the initiative that were designed to reduce barriers to obtaining services, including the provision of mobile services, an emphasis on the parent-child relationship in both early intervention and behavioral health settings, and improvement of cross-system communication and collaboration. The Helping Families Raise Healthy Children initiative demonstrates the potential gains associated with improved cross-system care, and could serve as a model for similar initiatives in a variety of domains.