depression prevention

Maternal depression leads to poor quality of life for the entire family, especially in low-income households where effective treatment is a challenge. Problem-solving education was found to be an effective depression prevention method in mothers of the Head Start community, a federally funded early-childhood education program for children and their families.


Head Start is a federally funded program that provides early-childhood education to low-income children and their families. Head Start serves approximately 1 million families each year in the United States. Alarmingly, of all the mothers of children enrolled in Head Start programs, about half of them suffer from depression, contributing to poor quality of life for mothers and children. In addition, depression in mothers is known to disproportionately affect low-income women. Therefore, coming up with additional strategies for depression prevention in low-income families is incredibly important as access to mental heath services can be a challenge in this population. Head Start provides an accessible community-based venue for assessing depression prevention strategies. Silverstein and colleagues assessed the problem-solving education (PSE) method, which consists of a total of 6 sessions of cognitive behavioral therapy. They published their results in JAMA Psychiatry.

The study included 230 mothers of children enrolled at one of6 Head Start centers in Boston, Massachusetts. To compare the potential benefits of PSE with real-world Head Start services, mothers were divided into two groups. One group received PSE, while the other group received regular Head Start services. These included family needs assessments, home visitation, parenting groups, behavioral health services, and assistance with food, job, and housing resources. The PSE group received 6 one-on-one workbook-based problem-solving sessions lasting 30-60 minutes, monitoring of depression symptoms, and formal mental health services as needed. The participants were followed for 1 year. During this time, depressive symptoms were recorded bi-monthly using the Quick Inventory of Depressive Symptoms (QIDS)and problem-solving skills were measured at 6 and 12 months.

While there was no significant improvement in problem-solving skills in either of the two groups, PSE decreased symptoms of depression in mothers who had lower symptoms at baseline. In other words, PSE improved depressive symptoms in mothers who had less severe symptoms to begin with. These results provide support for the use of PSE as a depression prevention intervention.Maternal depression can negatively affect children, so the use of PSE for depression prevention has the potential to benefit the entire family.

Reference: Silverstein, M. et al. (2017). Efficacy of a maternal depression prevention strategy in Head Start. JAMA Psychiatry.

Written by Liana Merrill, PhD

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