The voices of Urban Institute's researchers and staff
May 10, 2013

Health Reform Will Help Depressed Low-Income Mothers Get Treatment

May 10, 2013

 While we like to think of motherhood as a happy, even idyllic, state, in fact it is a stressful and difficult time for many women. Depression is widespread, particularly among low-income mothers. Studies at the Urban Institute find that 8.8 percent of all low-income mothers with young children experienced a major depressive episode in the past year and more than two-thirds of them were having difficulty coping with daily tasks.

Maternal depression is a two-generation problem because the children of depressed mothers also suffer. In the most severe circumstances, they may be neglected or abused. Further, these problems are often hidden due to stigma associated with mental health problems or fear of losing custody of children.

The good news is that when depression is identified, there are many effective treatments, including talk therapies and drug therapies. However, 37.3 percent of depressed low-income mothers with infants reported that they did not get any treatment. An important reason for the lack of mental health treatment is that low-income mothers often lack health insurance coverage or have poor access to mental health providers.

The Affordable Care Act (ACA) offers the best hope for helping these mothers get treatment because it will provide new insurance coverage to many who are uninsured. A recent study from Oregon published in the New England Journal of Medicine showed that providing Medicaid to previously uninsured low-income adults reduced their depression. It is too soon to know how many states will choose to expand Medicaid, but about 2.7 million currently uninsured parents nationwide would be eligible.

The ACA also includes provisions to improve the connection between primary care and mental health care. These two sectors have historically been in separate “silos,” with little communication between providers. Low-income mothers often have frequent contact with their child’s provider, but pediatricians may not have been trained (or do not have time) to screen for maternal depression and provide mental health counseling and drug therapy for adults. New initiatives (some funded by the ACA) are experimenting with placing counselors or “health navigators” in primary care providers’ offices to help mothers find the help they need.

Depression is a serious problem that many mothers are struggling with now, but we have reason for optimism that health reform will improve their opportunities for getting treatment.

Depressed Mother image from Shutterstock

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