Sunday, March 14, 2004

A Helping Hand

New moms find way out of depression

By Tim Bonfield
The Cincinnati Enquirer

Tamika Winstead sits Feb. 17 at her home in Winton Terrace with her son Christian, who will be two in April. Treatment for depression is helping Tamilka cope with the pressures of teen motherhood.
The Cincinnati Enquirer/ERNEST COLEMAN
Like most teen mothers, Tamika Winstead wasn't planning to have a baby.

She was still in high school. She had a boyfriend she loved at the time. She engaged in an adult behavior without thinking much about the adult consequences.

And when her son, Christian, was born April 10, Tamika would be the first to admit she wasn't really ready - even though she was committed to keeping the child.

So it comes as little surprise that Tamika - now 18 - was stunned and depressed by the life-changing demands of parenthood. What's unusual is that she got help - serious help - from experts in child health and depression who made more than 15 house calls to Tamika's apartment in Winton Terrace during the first few months of Christian's infancy.

"I feel it made a very big difference," Tamika says. "I used to hold everything in. I'd oversleep, overeat and cry. I didn't have anybody to talk to. (Now) I know I can handle situations I thought I couldn't handle before."

The help Tamika received came from a pilot maternal depression treatment project launched two years ago by Every Child Succeeds - a social service agency that has helped more than 6,000 families in seven Ohio and Kentucky counties since it was formed in 1999.

Launched: 1999. Based at Cincinnati Children's Hospital Medical Center, the program draws support from more than 20 community agencies.
Philosophy: To help young, first-time mothers and babies through home visits and other services aimed at stimulating early childhood brain development. The long-term goal is to improve skills children need for school while reducing child abuse and neglect and the risk of juvenile delinquency.
Families served: More than 6,000 since 1999.
Services: Regular home visits; extra visits for depressed mothers; free books, educational toys and home safety supplies; referrals as needed to substance abuse, job training and other support agencies; tracking child development until age 3.
Counties served: Hamilton, Brown, Butler, Clermont in Ohio; Boone, Campbell and Kenton in Kentucky.
Enrollment criteria: Must be either pregnant or have a baby under 3 months of age and meet at least one of these conditions: single, low income, received late or no prenatal care, or under 18 years of age.
Information: (513) 636-2830.
The agency works every day with the grim statistics of young motherhood and depression.

• While depression strikes 10 percent to 16 percent of new mothers in the general population, the condition hits as many as 45 percent of Every Child Succeeds clients.

• Studies have shown that depressed mothers don't bond as well with their babies. That in turn can lead to impaired social, emotional and cognitive growth for the child, and, in some cases, to outright child abuse.

• Historically, more than 70 percent of depressed women never get treatment, in part because they haven't sought it and in part because few services have been available. But a recent survey revealed that 88 percent of Every Child Succeeds clients were living with untreated depression.

Addressing mental health issues wasn't a major focus of Every Child Succeeds when it was launched. The agency's broad goal has been to provide training and materials to young mothers and their babies to help stimulate early brain development in hopes of making children better prepared for school.

Clients find Every Child Succeeds during pregnancy visits at hospitals and doctors offices across the region.

But the problems linked to depression became so obvious that the agency had to deal with them. Not only has the maternal depression program made a difference for local mothers, it may serve as a model for social service agencies in other cities, says president Judy Van Ginkel.

Tamika's situation reflects issues that many young mothers confront.

She left school before graduating to have her baby. She gets about $119 a month in welfare support to live in a subsidized apartment complex where a man was shot to death a few months ago in the courtyard outside her front window.

"I don't go outside very much," Tamika says.

She has no car. She has no job at the moment but has worked part time at two fast-food restaurants. Her former boyfriend isn't part of her life anymore, she says.

While facing all this, Tamika scored a 28 on a standard depression screening test given through Every Child Succeeds. Anything over 20 means a person is depressed.

Enter social worker Amy Novak, who has worked with more than 50 mothers as part of the two-year, $187,000 pilot program.

In addition to standard visits from Every Child Succeeds staff, Novak visited Tamika every week for 15 weeks. They spent an hour per visit talking about lots of things: how to control the anger that can come when a baby won't quit crying; how to play with a child in ways that stimulate development; how to set goals and take control of your own life.

"Mostly we worked on self-esteem," Novak says. "I could see the difference. I could even see a physical change in her face. She is so much more excited and proud of herself."

Instead of being paralyzed by the challenges in her life, Tamika is working to make things better. The neighborhood may be rough, but she has her own place, which gives her more control over who comes and goes. She has returned to school.

"I want to finish school so bad," Tamika says. She expects to graduate in June, after returning to classes at a program called Life Skills. This fall, she plans to enroll at Cincinnati State to study culinary arts.

The school has a day care that makes it possible to take the classes.

Earlier this year, Tamika took the depression test again. She scored a 7 - well within normal ranges.

It will be several more months before Every Child Succeeds can complete follow-up tests for most of the women in its depression program. And it will take years to track how the children may benefit from growing up in a household freed from depression.

But early data from the first 12 cases were encouraging. All but one was no longer depressed at the end of treatment, says Robert Ammerman, director of outcomes and evaluations for Every Child Succeeds.

"We're hopeful that what we've learned here will be relevant for other programs across the country," Ammerman says.

So have all of Tamika's problems been solved by the intervention of Every Child Succeeds? Hardly.

She still needs to follow through with her goals. She wants to move to a safer place, maybe with relatives in North Carolina. She wants to lose more weight and find the right man to share her life.

Tamika knows her road ahead will have its share of bumps. But now at least she has a map.

"I want to be the best mother I can be," she says.


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