How Obamacare Will Help Low-Income Mothers Battle Depression

Monday, December 17, 2012

Re-posted from ThinkProgress

By Sy Mukherjee

At an Urban Institute panel on depression and low-income Americans on Thursday, Marla McDaniel of the Center on Labor, Human Services, and Population pointed out that low-income American mothers are “more likely to have severe depression.”

Fortunately, Obamacare’s Medicaid expansion will help offer those low-income mothers the crucial preventative and mental health services they need to treat their clinical depression. Especially considering the economic disparity between those who are affected by depression — and the lack of sufficient treatment options for low-income Americans — states that choose to expand Medicaid under Obamacare will make important strides toward ensuring low-income mothers have the health resources they need:

Eighty two percent of infants living in households with depressed mothers were enrolled in Medicaid or CHIP programs, health care programs for low-income people, according to a separate 2010 report by the Urban Institute about children affected by maternal depression. Of the mothers, at least 40 percent were not receiving any treatment. Outcomes were consistently worse for uninsured families.
Having a lower-income household also affected the type of mental health provider treating the women, according to the draft paper. Ten percent of lower-income mothers visited a psychiatrist and received a prescription to treat their symptoms, about half as many as the higher-income mothers. Seven percent of the low- income mothers received treatment from social workers, compared to 2 percent of higher income women and 5 percent of the uninsured.

But states choosing to participate in the expansion of Medicaid could improve access to the prevention and treatment women need, said Larke Huang, a psychologist and senior adviser at the federal Substance Abuse and Mental Health Services Administration, who was also part of the forum. Medicaid currently covers pregnant women considered “medically needy,” who might not meet income requirements. The coverage continues until six months after they give birth. In states that expand the program, many of those women will now qualify for the program after the six-month period, she said.

In fact, when mothers’ depression goes untreated, it results in significant social costs that extend well beyond the early childhood period. According to Scientific American, depressed mothers are less likely to have a strong cognitive bond with their children or be employed, leading to excess stress in households — and ultimately perpetuating a vicious cycle in which untreated mental health conditions negatively impact the prospects of future generations.

Furthermore, a disproportionate number of Latino and African-American children live in single-mother household, and seven in ten children in such families are in a low-income household. These are communities that are already struggling with the effects of decades of racial and class bias — and a lack of preventative mental health resources only exacerbates that historical gap.

But while Obamacare’s Medicaid expansion could provide some relief to these families, GOP governors in poor states with high uninsurance levels have been refusing to take part in the program. So far, Nevada’s Gov. Brian Sandoval (R) — whose state has a high concentration of poor Hispanics and African Americans — has been the only Republican state official to embrace expanding his state’s Medicaid pool.