Association for Public Policy Analysis & Management

The Mother and Infant Home Visiting Program Evaluation (MIHOPE), a national evaluation of the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, is systematically examining how program features and implementation systems are associated with services delivered and impacts across four home visiting models designated as evidence-based by the U.S. Department of Health and Human Services: Early Head Start – Home-based option, Healthy Families America, Nurse-Family Partnership, and Parents as Teachers. MIHOPE was launched in 2011 by the Administration for Children and Families and the Health Resources and Services Administration and MDRC is leading the study in partnership with James Bell Associates, Johns Hopkins University, Mathematica Policy Research, the University of Georgia, and Columbia University. The evaluation is examining program implementation, impacts, and costs.

Families served by home visiting programs often face many stressors in their communities, such as poverty and violence, which can affect parents’ psychosocial well-being and contribute to a higher prevalence of mental health issues. Preliminary findings from MIHOPE, described in the 2015 MIHOPE report to Congress, revealed that at the time of study entry, a third of the women reported depressive symptoms and a quarter reported anxiety symptoms. As maternal mental health problems can have repercussions on both maternal and child well-being, the MIECHV program has encouraged grantees to focus on these issues and MIECHV-funded local home visiting programs are increasingly addressing mental health issues. For example, the preliminary MIHOPE findings found that a third of local programs increased the priority of mental health issues as a result of the MIECHV program, and many local programs initiated additional mental health screenings of mothers.

This presentation directly speaks to the conference theme of encouraging innovation and improvement by highlighting not only the strengths of the home visiting implementation system as it pertains to addressing mental health issues of families, but also areas of the implementation system that can be improved. This presentation will provide final results drawn from the MIHOPE implementation research report which will be published in summer 2018. In particular, it will capitalize on MIHOPE’s innovative multi-level, multi-informant research design, conducted with 88 local programs, to shine a spotlight on the goal of reducing mental health issues to inform practice by answering the following questions:

• What is the prevalence of mental health issues for women who participated in MIHOPE?
• What are local programs’ policies on screening families for mental health issues?
• How are home visitors supported by training, supervision, and external consultants to address mental health issues with families during home visits?
• How available are mental health services in the surrounding communities and what is the provision of family referrals to those providers?
• Do home visitors’ visit content and referral practices vary on whether families are identified as needing help to address mental health issues?

This presentation provides an opportunity to translate findings from MIHOPE into clear service-oriented lessons that home visiting stakeholders can use to strengthen the implementation system supports home visitors have at their disposal to address mental health issues with families.