maternal and child health and mental health: time for action ken thompson md associate director for...

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

Ken Thompson MD

Ken.Thompson@samhsa.hhs.gov

240.427.7911