Department of Psychiatry, University of California, San Diego, San Diego (Fettes, Sklar, Sandhu, Aarons); Child and Adolescent Services Research Center, San Diego (all authors); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Hurlburt).
Psychiatr Serv. 2021 May 1;72(5):539-545. doi: 10.1176/appi.ps.201900256. Epub 2021 Mar 11.
Profiles of depressive symptoms were identified among Hispanic, Black, and White parents involved in the child welfare service system, including changes in symptoms over time.
Participants (N=2,109) were parents receiving SafeCare, a home visitation intervention provided in a large, diverse child welfare system. Depressive symptoms were assessed with the Centers for Epidemiological Studies Depression Scale at baseline and at approximately every sixth home visit, up to a total of four times. Univariate tests examined the relationship between baseline symptoms, race-ethnicity, and service participation. Latent class growth analyses identified trajectories of depressive symptoms during participation in child welfare services.
Participation in services was affected by depressive symptoms. Forty percent of parents did not remain long enough in the program to complete a second CES-D assessment, and those who reported more symptoms at baseline were significantly less likely to do so. Among parents who engaged in services, distinct profiles of depressive symptoms emerged that differed by race-ethnicity. For non-Hispanic Black parents, no changes in depressive symptoms over time were noted, regardless of level of severity at baseline. Parents with the highest levels of symptoms did not improve over time.
Despite receipt of supportive and recovery-oriented services specifically focused on empowering child welfare-involved parents, many experienced elevated depressive symptoms. Integration of child welfare and community mental health systems may improve both service engagement and mental health among child welfare-involved families.
确定参与儿童福利服务系统的西班牙裔、非裔和白人父母的抑郁症状特征，包括随时间变化的症状变化。
参与者（N=2109）为接受安全护理的父母，这是一种在大型、多样化的儿童福利系统中提供的家访干预措施。在基线和大约每六次家访时使用流行病学研究中心抑郁量表评估抑郁症状，总共评估四次。单变量检验考察了基线症状、种族和族裔以及服务参与之间的关系。潜在类别增长分析确定了在参与儿童福利服务期间抑郁症状的轨迹。
服务参与受到抑郁症状的影响。40%的父母没有足够长的时间完成第二次 CES-D 评估，而基线报告症状较多的父母则不太可能这样做。在参与服务的父母中，出现了不同的抑郁症状模式，这与种族和族裔不同。对于非西班牙裔黑人父母，无论基线严重程度如何，都没有随时间变化的抑郁症状变化。症状最严重的父母并没有随着时间的推移而改善。
尽管接受了专门针对增强儿童福利涉及父母能力的支持性和康复性服务，但许多人仍经历了较高的抑郁症状。儿童福利和社区心理健康系统的整合可能会改善儿童福利所涉家庭的服务参与度和心理健康状况。
