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Mental Illness Hampers Mothers' Ability to Care for Children

CINCINNATI -- A new Children's Hospital Medical Center of Cincinnati study indicates that mental illness may play a significant role in hindering the ability of mothers to care for their children.

The study shows that one of four mothers who bring their children to a pediatric emergency department for care of non-urgent complaints have a mental health problem.

"A large proportion of these mothers with mental illness report having a hard time taking care of their children," says Jacqueline Grupp-Phelan, M.D., M.P.H., an emergency medicine physician at Cincinnati Children's and the study's lead author. "Mental illness may affect not only a mother's decision to bring her child for care, but also may affect her ability to care for her child once her child has been diagnosed with a problem.  The study was April 30, 2001 at the Pediatric Academic Societies Meeting in Baltimore.

Dr. Grupp-Phelan and her colleagues administered a mental-health screening test to 243 mothers of children who came to Cincinnati Children's emergency department between 5 p.m. and midnight with non-urgent complaints between April and June 2000.

Ten percent of the mothers had major depression, 8 percent low-grade depression, 8 percent anxiety disorder, and 12 percent somatic symptoms (such as headache and abdominal pain with no medical cause). Eleven mothers, 4 percent, were actively suicidal and required immediate referral. Overall, 25 percent of mothers had one or more of these mental health disorders.

"Of this 25 percent, more than half, 57 percent, stated that these problems made it somewhat difficult to extremely difficult to take care of their children the way they would like to," says Dr. Grupp-Phelan. "We need to understand more about how maternal mental health influences why they seek care and how these problems affect care plans once we prescribe them."

While the study has important implications for the care of children, it also is instructive in terms of the care of mothers. These mothers may seek care for their children but not for themselves. If this is the case, it raises the question of whether the pediatric emergency department may not be the most appropriate setting to screen mothers, because it may be the only opportunity for healthcare providers to have access to them, according to Dr. Grupp-Phelan.

---Pediatric Academic Societies

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