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The Healthy Generations Program: Improving Access to Mental Health Care

New model of integrated service delivery makes mental health services more accessible to teenaged parents

Dr. Amy Lewin is an assistant professor in the Department of Family Science in the School of Public Health. A clinical psychologist by training, Dr. Lewin comes to the University of Maryland after seventeen years on the faculty at Children’s National Medical Center in Washington, DC. Dr. Lewin is interested in finding innovative ways to make mental health services truly accessible and relevant to children and families.

Dr. Lewin’s current project is a study that evaluates the effectiveness of a new model of pediatric primary care delivery for teen parent families. This model integrates primary healthcare for parents and children, with social work, mental health, legal, and developmental services in the same office visit, with all the service providers forming a multidisciplinary team. Each family is encouraged to build trust and form long-term relationships with staff and service providers. The study follows two groups of low-income teenaged mothers from Washington DC. One group receives services through this integrated program called the Healthy Generations Program, and one receives standard pediatric primary care elsewhere in the community. The mothers are between thirteen and nineteen years old, and the fathers average one to two years older. The study follows each family for two years from the time of enrollment, which happens when the baby is about two months old. The study will test whether the parents and children enrolled in the Healthy Generations program have better physical health, behavioral health, and self-sufficiency outcomes than those in the comparison group.

“Access to mental health services doesn’t just mean services that are located in the community or are open for evening hours. Access is a much more complicated issue than that,” says Dr. Lewin. Although it is too early to present final results from the study, Dr. Lewin believes that having multiple services available within primary care could be a game changer for teen parents, who often lack reliable transportation or childcare, which makes it difficult to access mental health services built on a traditional model. Dr. Lewin hopes that, if found to be effective, the Healthy Generations Program could serve as a model for other programs to start integrating mental health services into settings such as primary care services and schools, which are already accessible to young families who would otherwise face significant barriers to receiving care. “The infrastructure to do this exists already,” says Dr. Lewin. “But resources need to be expended, and you need the institutional will to make those kinds of structural changes. Understanding the program’s effectiveness is the first step in making changes.”

Dr. Lewin’s team recently published a journal article sharing preliminary findings that “bust stereotypes” about teen fathers. Maternal depression was shown to be strongly associated with infant distress. But in families where fathers were regularly involved in their babies’ lives, their influence was protective against the adverse effects of maternal depression. “Young fathers actually do have a really important role to play in the well-being of their children, even as early as the first few months of life,” says Dr. Lewin.

“I have great respect for these young parents,” says Dr. Lewin. “I am a mother of two children myself. Even with every advantage, it’s still the hardest thing I’ve ever done. I’m eager to find new ways that we can help young families, as service providers and as a community.”

Read more about the Healthy Generations program

Read the journal article in Maternal and Child Health