Prevention and wellness across the lifespan: Screening for perinatal and interconceptional depression in Women, Infants, and Children (WIC) programs in California

Depression can negatively affect a woman's pregnancy, her baby's health, and the health of her other children. A California Bay Area County WIC program piloted the Perinatal and Interconceptional Depression Screening and Education Project. The Patient Health Questionnaire 9 (PHQ-9) was used to screen WIC clients who were pregnant or had a child under 5 years. WIC educational classes on depression symptoms and how to obtain medical care were held. Depending on depression severity, women were referred to community resources, the mental health access line, public health nursing, or the crisis center. A total of 27,406 WIC clients were screened from May 2010 to February 2011. Overall, one in four (25.2%) were depressed -- 16% mildly, 5.8% moderately, 2.1% moderate-severely, and 1.3% severely. Subsequent screening of 2123 women indicated money issues and sleep deprivation as key depression contributors. A follow-up sample of clients who suffered moderate to severe depression (N=80) revealed that 81% improved significantly on their screening score three months after their initial screening, with 62.5% reported receiving help. Wellness promotion during perinatal and interconceptional stages of a woman's life is critical for the health of depressed women and their families. WIC is a feasible, ideal site for depression screening and should be implemented as standard protocol.