Developing an Integrated Model for Home Visitation

Perinatal depression is a significant concern, particularly for low-income women. Many cases
of perinatal depression are complicated by comorbidities such as post-traumatic stress
disorder symptoms, anxiety, and intimate partner violence. Providing perinatal mental health
services to women in home visiting programs could have considerable public health
significance. This study will develop and test an integrated model of mental health services
embedded within home visitation (HV) programs. This model will (1) incorporate a protocol for
systematic screening and referral; (2) strengthen formal linkages between HV programs and
other components of service systems; (3) promote the capacity of service systems to provide
evidence-based early intervention and treatment for depression; and (4) facilitate the
receipt of early intervention and treatment services for perinatal depression and comorbid
conditions. This will be the first model to our knowledge that systematically integrates
screening, referral, and early intervention and treatment for perinatal depression and
associated comorbidities within HV programs.

The specific aims are:

1. To develop an integrated model of perinatal depression care within HV programs. This
integrated model ("SCRIPT") will incorporate screening, referral, and individualized
prevention and treatment services.

2. To assess the feasibility of implementing the SCRIPT model with high fidelity in two HV
programs. One HV program—DRUM Healthy Families—will use paraprofessionals as
interventionists while the other program—M&I Nursing—will use nurses and social workers
as interventionists.

3. To determine the impact of the SCRIPT model on depressive symptoms and major depressive
episodes.