Maternal and Child Health and Mental
Health:Time for Action
Ken Thompson MDAssociate Director for Medical Affairs
CMHS/SAMHSA
CityMatCH TeleconferenceJune 28, 2007
The Mental Health Imperative:
Inventing the neck
Human Capability
Motivation
Concentration
Organization
Patience/Tolerance
Problem solving
Sociability
mental health in impoverished women of
childbearing age
Population(s) at risk
Ecology of Disability, welfare and poverty-
Drift and causation- incidence and prevalence
What we think we know
Homeless and low income housed single mothers- 2/3rds have lifetime Axis I diagnosis (Bassuk et al. 1996)
Approximately 20% of working, single mothers, women on welfare and non working single mothers had DSM III diagnosis in past year (Jayakody and Stauffer 2000)
In the 52% of women experiencing barriers to employment, 34% had depression, ptsd or anxiety (Danziger et al. 2000)
more....
In Pittsburgh in 158 women on Tanf (Gorske et al. 2006)
67% met criteria for Axis I diagnosis
In order of prevalence- Panic Disorder, Major Depression, Alcoholism, Drug Abuse, Dysthymia, PTSD, Agoraphobia
36% had more then 1 diagnosis
more....Almost 50% reported significant histories of either physical and emotional abuse/neglect or sexual abuse.
A history of abuse was significantly correlated with psychiatric and functional impairment
More then psychiatric impairment (per se), impaired cognitive ability predicted impairment of employment
High rates of tobacco use
Types of Psychiatric Impairment
Panic Disorder with/without agoraphobia
Major Depression (Bipolar Disorder)
PTSD
Generalized Anxiety
Alcohol and Substance Abuse
Personality Disorders
Psychosis- Schizophrenia and others
Physical Disease
Addiction
Psychiatric Disorder
ResponsePresumption of high likelihood of a variety of impairments and the need to address them
Screening
Easy access to integrated care and treatment
Engage in recovery- peer specialists?
Deal with disability
Address family and their burdens
Illness Health
The way I used to think
Ill Not Ill
Healthy
Not Healthy
How I have learned to think
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