WBUR

House Calls Lift Spirits Of Depressed Moms

Laura Starr, a social worker with the Visiting Nurse Association of Boston, makes a house call to a young mother suffering from depression. (Sacha Pfeiffer/WBUR)

Sunday is Mother’s Day, when many will celebrate their mothers and the joys of being a parent. But mothering isn’t always sunshine and rainbows. In fact, research shows 10 to 20 percent of women with young children suffer from depression. For low-income women, those numbers more than double. So there’s a new effort in Boston to help depressed moms — and ultimately their children.


BOSTON — Laura Starr rolls a small suitcase along a sidewalk in Brighton. She’s a social worker who makes house calls, and this luggage is her office. On this day, she’s visiting a depressed mother.

Fabiola, 31, moved here from Guatemala seven years ago and has clinical depression. She used to do home renovation work, but now she stays home with her two-year-old daughter, who’s going off to spend the day with relatives.

After Fabiola kisses her daughter goodbye, the two women sit down to talk. Laura asks her how many days in the past week she’s felt depressed. “Three or four,” Fabiola replies. When Laura asks Fabiola how much she enjoys life, she answers quietly with just two words: “Un poco.”

“This tells me that your depression is a little bit worse this past week,” says Laura, who works for the Visiting Nurse Association of Boston.

Fabiola is part of a new program that sends social workers to the homes of low-income mothers. Fabiola says she really needs Laura’s help.

Some studies show depression rates among low-income mothers range as high as 60 percent.

She says she wishes her mother or sister lived nearby to help her with child care. Sometimes her daughter wants to do puzzles with her or have tea parties, but Fabiola says she feels so depressed she’d rather do nothing at all.

After her visit with Fabiola, Laura remarks how unsurprising it is that some mothers get depressed; she’s a young mom herself, so she understands.

“After having my own daughter, I realized, ‘Wow, this is really not a Betty Crocker commercial,’” Laura says. “This is really hard.”

It’s even harder for the women Laura visits because many of them are poor and struggle with English. That means they’re less likely to get treatment for their depression because they can’t afford it or they don’t have transportation or they’re afraid to leave the house. Others think they’ll be stigmatized if they admit they want help.

Depression rates among low-income mothers can range as high as 60 percent, according to the National Center for Children in Poverty. That’s because young mothers who are economically disadvantaged often struggle more with substance abuse, domestic violence, difficult relationships, a lack of social supports, and even an absence of hope than mothers who are financially better off.

“Depression is something that really has a pervasive effect on somebody’s life,” Laura adds. “It affects how they view themselves, it affects how they view the world. There’s really nowhere that depression doesn’t touch — and ultimately on the children.”

That impact on children is what this program ultimately wants to reverse, because maternal depression doesn’t just take a toll on the mom.

“When that mother isn’t responding to the cries, isn’t responding to the vocalizations and the cooing and the babbling and all those wonderful things that babies do, it’s amazing the impact it has on the actual development of the brain,” says Laurel Deacon, of the United Way of Massachusetts Bay and Merrimack Valley, which funds the program.

“Even neuroscientists would now say that the single most important factor in the development of the child’s brain is the relationship with the primary caregiver,” says Dr. Bill Beardslee, a child psychiatry professor at Harvard Medical School who has studied maternal depression for 30 years.

Dr. Beardlese says depression in mothers can lead to emotional and behavioral problems in their children, among other issues.

“These kids, when they’re older, have higher rates of depression, they have higher rates of school difficulties when they’re very young, they have more medical problems,” he adds.

But depression is also highly treatable. Since the program started in March, it’s identified 15 low-income women in Allston and Brighton as being depressed. Nine of them have signed up for treatment.

The appointments at their homes cost them nothing. But Fabiola says what she gets from Laura’s visits is invaluable.

“I feel better when I talk about my feelings and my depression” Fabiola says.

She says she doesn’t trust just anyone to talk about her feelings, but she does trust Laura to help her work through her depression — because not only will Fabiola benefit, but so will her daughter.

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  • Erica Quinn

    I think this is an invaluable service. As Laura implied, the realities of motherhood are intense and it can be difficult to cope with or without depression. Having resources available is essential and I am so greatful that we have social workers to help out. Bravo.

  • Stephanie Rand

    As a Latina living in Boston with access to Gold Standard care, I also felt isolated and scared not having family around to support me after the birth of my daughter. I was thankful that I was resourceful enough to seek out Mom’s groups, and have insurance to cover medication and therapy – alot of women are not so fortunate. To know that there are services and care givers like Laura available for them is a blessing. We have got to get more funding for these services and we have to get the word out to women that these services exist!!

  • Pat

    I hate sexist programs like this. What about depressed fathers? Especially single fathers raising a child alone. Granted that is not as common, but there are hardly the resources for them that women get. Programs like these should not have biased restrictions based on sex, or for that matter ethnicity, age, sexual orientation, etc. Any depressed parent of a young child should be able to apply for assistance, not just women. If there was some program just for men feminist groups would be screaming bloody murder. I’m sick of these double standards, nearly every support program similar to this one focuses solely on the mother. As a working mother myself with a stay at home husband who suffers depression I’ve run into these sexiest road blocks too many times. Any program funded with tax payer dollars should not discriminant period.

  • Stephanie Rand

    Pat, you bring up a VERY interesting point and Men and Depression. The reality is that your husband IS in the minority, and statistically, men tend to suffer in silence, more so than women. These programs exist, because it is the mothers who are usually the primary care givers. Having gone to groups provided by some non-profits, like the one Laura works for, I can tell you – most of them are privately funded. If you are seeking help for your husband, I would contact the United Way – they can help find an organization in your area. Best of luck to you!

  • Pat

    Stephanie thanks for your recommendation. If this program is indeed funded with private money than they have the right to do whatever they want. I can only urge them to be more open minded. But if any money, grants or assistance comes from the public domain they should not discriminate. Don’t get me wrong, it’s great that programs like this exist. However fathers raising children are often overlooked and discriminated against when it comes to public assistance. For example there are state programs that offer special housing for single mothers raising children. However single fathers are excluded for the program and there is no counterpart program for single fathers. Granted there are far more more single mothers in need of assistance than fathers, probably 1 to 50. But that 1 father has a lot less options.

  • sharon

    Just because you can reproduce does not mean you should!

  • Monika

    Pat-I agree with you, I know a recently-divorced single father who is battling depression. I actually think it’s more common than people think.

    Like many who commented, I am grateful for this program. However, I was disappointed that the article didn’t mention what I feel is the elephant in the room: Why do you think impoverished women with children are more likely to be depressed? Under these environmental stressors, anyone would be depressed. I believe 40% was one prevalence estimate in this demographic; removing the poverty part would likely remove a lot of that. It’s kind of like trying to counsel someone on lifestyle practices to prevent cancer and then expose them to tons of radiation; going after the radiation would obviously be more fruitful in that case. For the woman in the article, I bet if she were reunited with her family, her depression would go away. I am a public health professional and I see this too often. We help the individual trees, but fail to see the problem with the forest.

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