Although as many as a fifth of new mothers in the United States develop post-partum depression (PPD), studies show that foreign-born Latinas are at even greater risk than the general population. They are also less likely to receive treatment due to factors including language barriers and challenges accessing health care.
Rheanna Platt, assistant professor of psychiatry and behavioral sciences and medical director of the Latino Family Clinic at Johns Hopkins Bayview Medical Center, says that preventing or decreasing the likelihood of PPD will improve a family’s overall wellbeing – also resulting in better mental health for the children.
Studies have shown that early childhood learning centers (ELCs) where women regularly bring their children can serve as a point of contact to assist them as well. In 2020, the psychiatrist led a research team investigating how virtual prevention programs at such trusted sites might offer women the group-based social connection and support that could lessen the likelihood of depression. She says the resulting report, published in the journal Women’s Health Issues in 2023, is one of the first aimed at those Latina immigrants who face stark disparities in mental health care.
As part of the study, 49 Spanish-speaking mothers participated in one of four virtual ten-session groups at ELCs in Baltimore. The program used the Mothers and Babies (MB) approach, an evidence-based intervention that combines strategies from cognitive behavioral therapy with principles from attachment theory. Based on input from women attending ELCs and ELC staff, Dr. Platt and colleagues from Northwestern University adapted MB to create a virtual program “package.”
In addition to core MB content delivered by bilingual community mental health providers and ELC family service coordinators, each 60-75-minute virtual session included information about child health delivered by a pediatrician, and program participants could receive additional assistance with accessing supplemental nutrition programs and benefits.
Researchers evaluated the program’s success through individual interviews as well as by before and after surveys that measured participants’ depressive symptoms, their parenting stress, and their confidence in managing challenging or negative emotions.
Results showed “significant” improvements in all three categories, providing initial evidence for the effectiveness of such programming delivered in partnership with local ELCs. According to the study: “These findings have important implications for extending the reach of preventive interventions among a population that faces many structural and linguistic barriers to traditional forms of mental health service delivery.”
Moreover, the study showed that group meetings held online increased participation. “A lot of the moms had headphones on and had joined the sessions from work,” Platt says. “There’s no way they would get permission to take a few hours off to attend a meeting at a center.”
The psychiatrist is no newcomer to this work. In 2015, she launched an in-person study of 100 Latina parents who brought children aged newborn to five to well-baby visits at Johns Hopkins Bayview Medical Center.
Using surveys, in-depth interviews and childhood records, she gathered data on the women’s personal health care access that revealed financial struggles, documentation concerns, fear of violence and relationship discord.
All the mothers interviewed expressed interest in mental health interventions within the pediatric primary care setting.
“Our best hope,” Platt said then “is to learn more about Latino parents’ struggles in order to design programs to promote their well-being – and in turn, their children’s.”
Now, with promising outcomes from the group-based virtual interventions, she is working with colleagues at Northwestern University on a study funded by the National Institute of Minority Health and Health Disparities. It will test the effectiveness of the intervention with 300 perinatal women attending Judy Centers, early learning hubs across Maryland that help families learn new ways to engage with their children. Her team will also collect information on program implementation to inform future program delivery.