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Maternal and Child Health and Mental Health: Time for Action

Maternal and Child Health and Mental Health: Time for Action. Ken Thompson MD Associate Director for Medical Affairs CMHS/SAMHSA CityMatCH Teleconference June 28, 2007. The Mental Health Imperative: Inventing the neck. Human Capability. Motivation Concentration Organization

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Maternal and Child Health and Mental Health: Time for Action

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  1. Maternal and Child Health and Mental Health:Time for Action • Ken Thompson MD • Associate Director for Medical Affairs • CMHS/SAMHSA • CityMatCH Teleconference • June 28, 2007

  2. The Mental Health Imperative:Inventing the neck

  3. Human Capability • Motivation • Concentration • Organization • Patience/Tolerance • Problem solving • Sociability

  4. mental health in impoverished women of childbearing age • Population(s) at risk • Ecology of Disability, welfare and poverty- • Drift and causation- incidence and prevalence

  5. 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)

  6. 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

  7. 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

  8. 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

  9. Physical Disease Psychiatric Disorder Addiction

  10. Response • Presumption 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

  11. The way I used to think Illness Health

  12. Healthy How I have learned to think Ill Not Ill Not Healthy

  13. Ken Thompson MD Ken.Thompson@samhsa.hhs.gov 240.427.7911

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