Boston Medical Center has joined forces with the Action for Boston Community Development's Head Start program to reduce and prevent depression in mothers of Head Start students.

Maternal depression affects about 12 million women in the United States annually and disproportionally impacts low-income and minority women. In a five-year pilot program, reported as a study in the June 14 online issue of JAMA Psychiatry, BMC trained and certified 15 Head Start staff members who were lay health workers to deliver brief interventions called problem-solving education, which included depressive symptom monitoring and referrals. The sessions were conducted during home visits or at Head Start locations.

Mothers who went through the educational sessions experienced a 40 percent reduction in the emergence of clinically significant depressive symptom episodes. Those whose initial screening indicated low depressive-symptom levels experienced a 61 percent reduction.

“We’re at the point of moving health care to accountable care models and taking care of populations. This reaffirms that an ounce of prevention is worth a pound of cure,” says Michael Silverstein, M.D., BMC’s associate chief medical officer for research and population health and the study’s first author.

The program also highlights the benefit of using lay health care workers. “That’s a big driving force. We can use this model with existing [Head Start] staff while BMC provides the technical assistance,” says Yaminette Diaz-Linhart at BMC, who ran the pilot.  

The program additionally shows how hospitals can make a difference beyond their walls.

“Hospitals can really augment services by forging clinical alliances with community organizations, especially ones not typically thought of in the health care context. Partnering with organizations like Head Start helps to provide care where the patients are,” says Silverstein.

Yvette Rodriguez, vice president of Head Start & Children’s Services in Boston, agrees.

“You have to see the child as a whole. It’s not just cognitive development. Children are impacted by what’s going on in the family and community. It’s not good for the kid if he goes home to a mom who’s depressed. If the family is not stable and the children not fed, they won’t learn, and that contributes to the achievement gap. The more support they have, the better society we will have,” Rodriguez says.