External support offsets the risks to children's health posed by maternal depression, study finds

"Being a mother with depression carries increased risks for a child's physical and psychological health," says Dr. Sarah Dow-Fleisner, Assistant Professor in the School of Social Work and Director of the Center for the Study of Services to Children and Families at UBC Okanagan. "But it's not fated to be, especially if mothers have external supports."

Dr. Dow-Fleisner's findings, recently published in the Journal of Family Issues, have important implications for how social workers and clinical practitioners—as well as families and communities—can help.

While a lot of research focuses on the postpartum period during which the rate of depression among mothers is highest, Dr. Dow-Fleisner wanted to focus on depression occurring later in childhood. Her team used data from a large longitudinal US study to compare depressed and non-depressed mothers of nine-year-old children.

Her analyses revealed that mothers with depression were more likely to report parenting stress and less likely to view themselves as competent parents as compared to non-depressed mothers. They also reported engaging in more disciplinary tactics, including nonviolent tactics like taking away privileges as well as aggressive tactics like cursing or threatening the child.

In terms of involvement, they were less likely to be involved at the child's school, such as attending an open house. However, they were equally likely to be involved in home activities, such as helping with homework.

"Furthermore, mothers with depression reported fewer interpersonal supports and community resources than mothers without depression," says Dr. Dow-Fleisner. "This is consistent with previous research."

Interpersonal supports refer to both emotional and material help from others, such as a relative providing advice or emergency childcare. Community resources refer to safety and neighborhood cohesion. Neighborhood cohesion measures the willingness of neighbors to help and the shared values of the neighborhood, among other social and trust factors.

"Notably, those mothers with depression who reported higher levels of support and cohesion felt less stressed and more competent in their parenting," says Dr. Dow-Fleisner. "These positive perceptions translated to less psychological aggression-based discipline and more home and school involvement with their children."

These findings fit with a resilience perspective, whereby mothers facing adversity like depression can still thrive as parents—especially when these protective factors are present.

"We want to help moms both address their depression and improve the child's health and well-being—this is known as a two-generation approach," says Dr. Dow-Fleisner. "As mothers may not seek out help for their depression alone, a child health check-up in a primary care setting is a good opportunity to screen for maternal depression and provide support in identifying interpersonal supports and community resources."

Dr. Dow-Fleisner adds that supportive programs should go beyond addressing immediate parenting problems and instead build capacity. For example, a community-based parenting support group could help a mother to build a network of people who could provide material and emotional support as needed. Dr. Dow-Fleisner cites Mamas for Mamas as one such community-based group. Mamas for Mamas, with branches in Kelowna and Vancouver, builds community and provides material as well as other supports for mothers and other caregivers.