Some practices may have concerns about screening adults in a pediatric practice (Chaudron et al, 2006).

• If your practice is one of these, consider gathering information about local and national mental health resources to provide to mothers, and potentially collaborate directly with their mental health and HCPs.
• Consider a community “mixer” to identify local mental health resources and dyad (infant) mental health resources to make effective linkages for mothers and families. Understand the limitations of health insurance coverage of mental health for adult women.

HCPs and office staff may have questions regarding how to maintain appropriate records when screening mothers for depression. In family practices, both the new baby and the mother are likely to be patients, which eliminates the need for unique record-keeping procedures. However, in pediatric offices and some family practice situations, the mother is not the patient, and questions will arise as to whether the maternal depression screen can or should be kept in the child’s record.

Regarding this issue, this same consideration applies to any other documentation of family psychosocial risk factors (Adverse Childhood Experiences [ACEs]). To highlight this as a concern, with maternal depression screening specifically, may create an unnecessary barrier. Primary care professional’s need to address all content in the record that should have special confidentiality, such as adolescent records. In addition, there may be concerns involving confidentiality such as divorce proceedings records and other issues. Think about how you would currently document a concern about maternal depression in your patient’s chart, and follow the same logic.