The Crying Clinic: Increasing accessibility to Infant Mental Health services for immigrant parents at risk for peripartum depression

What is the research about?

The Crying Clinic (CC) is a pilot initiative which aimed to reduce barriers and stigma related to using traditional infant mental health services for immigrant parents at risk of peripartum depression (PPD). The CC is a walk-in service that supports maternal well-being and healthy parent-infant relationships, located in a culturally diverse Canadian community.

Psychotherapeutic interventions for mothers with PPD and their infants have been shown to improve maternal depression, parenting stress, and interactions with their infants. However, immigrant families face significant barriers when it comes to accessing these services. One of the major shortcomings is that any mental health services fail to take cultural background into consideration, further contributing to these barriers.

The clinic’s name was chosen to attract highly stressed parents. Infant crying is a salient cue, which is used by infants to signal a need for comfort and safety. Often, parents who are vulnerable to depression, and report  higher instances of infant crying. Additionally, CC was chosen to reduce the bias, stigmas and misunderstandings associated with the term “infant mental health”.   

What did the researchers do?

The researchers designed an accessible innovative walk-in service located at an established community-based Infant mental health program. The CC interventionwas structured around a brief, one-session walk in service intended to act as a gateway for existing infant mental health services. The CC protocol was informed by best practice Infant Mental Health principles, and cultural literacy. The session goals were to provide families with a solution-focused assessment, and relational and psychoeducational intervention for infant and toddler behaviours such as crying.    

What do you need to know?

PPD is the second leading cause of disability among women during their childbearing years. Immigrant parents are at a high risk of PPD due to pre- and postmigration stressors. This mental health concern not only impacts mother-child relationships, but entire families and immigrant communities. Barriers to mental health services for migrant mothers may include culture shock, acclimatization to unfamiliar systems, and challenges with a new language. This study demonstrates creative ways to overcoming the challenge of engaging highly vulnerable parents from culturally diverse backgrounds.

What did the researchers find?

The researchers found 3 key findings in this study. First, the name and format of the CC contributed to accessibility for newly settled families who reported limited peer and family support. Secondly, participant families reported that CC sessions recognized and respected their culture and beliefs, as well their individuality. Finally, the design of the CC (accessibility, visibility, ease of physical access, etc.), may reduce stigmas and barriers for infant mental health treatment services in immigrant communities.

How can you use this research?

While vulnerable immigrant groups have more barriers to accessing infant mental health services, this study demonstrates creative ways of overcoming and addressing these challenges. This study shows that gateway models like the CC have the potential to enhance traditional infant mental health programs for highly vulnerable parents from diverse cultural backgrounds. Thus, provides a useful reference for future studies on accessible infant mental health services for immigrant families.      

About the researchers

Y. Bohr, C. Psych., Associate Professor, Department of Psychology, York University, LaMarsh Centre for Child and Youth Research, Toronto, Canada.

M. Bimm, PhD candidate, Department of Psychology, York University, LaMarsh Centre for Child and Youth Research, Toronto, Canada.

K. Bint Misbah, PhD candidate, Department of Psychology, York University, LaMarsh Centre for Child and Youth Research, Toronto, Canada.

R. Perrier, PhD candidate, Department of Psychology, University of Montreal, Montreal, Canada.

Y. Lee, PhD candidate, Department of Psychology, York University, LaMarsh Centre for Child and Youth Research, Toronto, Canada.

L. Armour, Manager Brief Services (formerly Therapist, Infant Mental Health Team), Strides (formerly Aisling Discoveries Child and Family Services), Toronto, Canada.

N. Sockett-DiMarco, Manager, Counselling Services, Strides (formerly Aisling Discoveries Child and Family Services), Toronto, Canada.

Citation

Bohr, Y., Bimm, M., Bint Misbah, K., Perrier, R., Lee, Y., Armour, L., & Sockett‐DiMarco, N. (2021). The Crying Clinic: Increasing accessibility to Infant Mental Health services for immigrant parents at risk for peripartum depression. Infant Mental Health Journal, 42(1), 140-156.

Keywords

Barriers to treatment, immigrant parents, infant mental health service, peripartum depression