The Problem

When left untreated maternal mental illness has a devastating effect on children, families, and the community.

Low-income mothers experience many barriers to mental health care including access, cost, stigma, and cultural differences.

Yet, more than 50% of low-income mothers, living in urban areas like D.C., experience depression at some point after delivery. [4]

 

Scope

Approximately 20% of women will suffer from depression, anxiety, or other mood disorder, during pregnancy, or shortly after. [2]

1 in 5 families, in the D.C. and surrounding areas, live below the Federal Poverty Level. [3]

“Depression is a particularly serious problem for low-income mothers, since it can create two generations of suffering, for the mother and her children.” The Urban Institute. [6]

 

The Effect

Post-Partum Depression

After birth, the significant change in hormone levels can trigger an unhealthy shift in mood. Physical fatigue, and sleep deprivation can exacerbate symptoms including: insomnia, persistent sadness, lack of interest in activity, high anxiety, change in appetite, irritability, feelings of guilt, and thoughts of harming oneself or baby. {4]

Maternal Mental Illnesses

Some mothers may also experience anxiety, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder, or other mental illnesses. Additionally, postpartum psychosis may occur, although rarely, effecting less than .5% of new mothers. [2]

Effect on Child Development

Maternal mental illness disrupts the ability to parent well. This is especially damaging to children living in poverty since strong support is needed to help combat the hardships of poverty. Thus, poor children of mentally ill mothers are at greater risk for delayed language development, as well as impaired social and emotional development. [5]

The Hurdles

Increased Risk Factors

Women with a current mood disorder, or personal or family history of mood disorders, are at increased risk of developing postpartum depression. [1}

Barriers to Care

Low-income mothers experience many barriers to mental health care including access, cost, stigma, and cultural differences. 2

Professionals who work with this population regularly say . . .

Cost: Even if they have insurance, they just don’t have the co-pay . . . “I can’t tell you how many people won’t go if [their insurance requires a] co-pay, they just don’t have the money.” [2]

Fear & Shame: Women worry that Social Services may take their baby away if they discover something is mentally wrong with them. [2]

Transportation & Childcare: “Whether it’s not having child care, or you can’t go to the appointment because you don’t have a bus ticket. Or, you don’t have gas in your car. All of those things are real and those prevent people from accessing the care that they need.” [2]

Cultural Stigma: Some African American moms have received a clear message from their peers, “That’s a white woman’s disease. We don’t get that.” [2]

Trust: “Historically, many African Americans have used the family and the church as sources of social support and have been less trusting of formal counseling mechanisms.” Norma Day-Vines, PhD [12]

Cost to Society

Quantitative

Healthcare System Burden

  • “Children of depressed mothers have higher medical claims than do children of healthy women because they bear a higher burden of illness, use health care services more frequently, and have more medical office and emergency department visits.”

  • National Business Group on Health. [6]

  • “Women who suffer from depression during pregnancy, and their infants, are at risk for costly complications. Nearly $15 billion dollars is spent on childbirth-related hospitalizations.” the Urban Institute. [6]

Lost Income and Productivity Alone

The annual cost of untreated maternal depression in the U.S. is $5.7 billion dollars each year. [6]

Public Schools

On average, each “at-risk student” costs an extra $8,667 per year to educate and manage with special services. [7] 

Increased Risk of Harm

Mothers with postpartum depression are17% less likely to consistently use a car seat. [6]

Qualitative

Immediate and long-term effects

“Untreated postpartum depression has been associated with serious consequences, most notably impaired mother-infant bonding and long-term effects on emotional, behavior, and cognitive skills.” —National Research Council. [6]

Homelessness

There is “… robust evidence that maternal mental illness places families with young children at risk for homelessness.” — American Journal of Public Health. [6]

As Children Age

“Older children of mothers depressed during infancy show poor self-control, aggression, poor peer relationships, and difficulty in school.”  — Maternal Child Health Journal. [6]

Adolescent mental illness and behavior problems

“Adolescents with a history of exposure to maternal depression have higher rates of major depression and other disorders such as anxiety, conduct disorders, and substance abuse disorders. This is of particular concern because depression that begins early in life is associated with a greater severity of illness and a higher risk of suicide and other violent behavior.”  — Zero to Three [6]

 

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