Conceptualizing integrated service delivery for pregnant and parenting women with substance use issues: defining key factors and processes

Integrated substance use treatment programs for pregnant and parenting women provide comprehensive services designed to meet the complex needs of women and their children. Meta-analytic data associate participation in these programs with positive outcomes relating to maternal substance use and mental health, and child development. Given that programs are typically developed to meet locally determined needs and depend on available resources, considerable heterogeneity in treatment models and services exists. Further, little is known about process-related factors that support the integration of substance use and prenatal/parenting/child services within and between agencies. This study employed concept mapping methodology with a group of expert participants to examine their perceptions of factors and processes that support effective integrated service provision for this population. Multidimensional scaling and hierarchical cluster analysis were used to derive and define requisite factors and to examine their relative importance. Findings are discussed in relation to a preliminary conceptual framework for integrated service provision.

Conceptualizing integrated service delivery for pregnant and parenting women with substance use issues: defining key factors and processes

Integrated substance use treatment programs for pregnant and parenting women provide comprehensive services designed to meet the complex needs of women and their children. Meta-analytic data associate participation in these programs with positive outcomes relating to maternal substance use and mental health, and child development. Given that programs are typically developed to meet locally determined needs and depend on available resources, considerable heterogeneity in treatment models and services exists. Further, little is known about process-related factors that support the integration of substance use and prenatal/parenting/child services within and between agencies. This study employed concept mapping methodology with a group of expert participants to examine their perceptions of factors and processes that support effective integrated service provision for this population. Multidimensional scaling and hierarchical cluster analysis were used to derive and define requisite factors and to examine their relative importance. Findings are discussed in relation to a preliminary conceptual framework for integrated service provision.

Mental Health and Wealth: Depression, Gender, Poverty, and Parenting

Depression is a common and debilitating condition that adversely affects functioning and the capacity to work and establish economic stability. Women are disproportionately burdened by depression, and low-income pregnant and parenting women have particularly high rates of depression and often lack access to treatment. As depression can be treated, it is a modifiable risk factor for poor economic outcomes for women, and thus for children and families. Recent national and state health care policy changes offer the opportunity for community-based psychological and economic interventions that can reduce the number of pregnant and parenting women with clinically significant depressive symptoms. Moreover, there is strong evidence that in addition to benefiting women's well-being, such reforms bolster children's emotional and social development and learning and help families rise out of poverty. This review summarizes the mental health and economic literature regarding how maternal depression perpetuates intergenerational poverty and discusses recommendations regarding policies to treat maternal depression in large-scale social services systems.