Depression is common, yet talking about depression with families can be difficult. Staff may worry about saying the wrong thing or that talking about depression may make it worse. However, talking about it is the first step toward supporting families to get the help they need.

Supportive Program Policies and Practices

Conversations about depression are more likely to go well when the Head Start program has policies and practices to support these conversations. Programs can create an environment where people feel open to having mental health conversations. Open conversations about mental health reduce the stigma often associated with mental health challenges and seeking help. Training in depression and mental health treatment can make it easier for staff to talk to a family member who may be depressed. Everyone benefits when a program can provide useful information about the signs of depression, its impact on families, and where to get help.

Conversations about depression go best when staff:

• Have training about depression, including what it is and common signs that someone may be depressed.
• Understand the warning signs and what to do during mental health crises.
• Can talk to a trusted supervisor or their colleagues about their feelings. Talking about depression and mental health can be emotional for everyone involved. Staff should have access to support.
• Have the resources to refer families for more assessment and treatment if needed.
• Receive ongoing training and support on topics related to depression, such as family engagement, adversity, trauma, stigma, resilience, nurturing relationships, and equity.
• Regularly talk about depression with families or regularly practice talking about mental health by role-playing in staff meetings.
• Use a depression screening tool with families. When using screening tools, be sure to train staff and support them throughout the screening process, such as partnering with the program’s mental health consultant.

Conversations about depression go best when families:

• Understand that the Head Start program cares not just about their child’s well-being but also the family’s well-being. They will be more prepared for questions about their own feelings and behaviors.
• Have been introduced to the topic of depression in other ways. The topic of depression can be introduced at a program orientation, Policy Council meeting, family engagement event, or during the first home visit. If families have heard about depression in a Head Start context before, they are less likely to be surprised if a staff member asks them about it.
• Know how depression can impact children and families. Information about depression can be shared through posters, printed materials, or in-person meetings.

Tips for Talking with Families About Depression

When talking with families, be prepared to:

• Show empathy. Families are more responsive when you show genuine care.
• Avoid judgment or labeling. Judging or trying to diagnose their feelings can turn families away from getting help.
• Remain calm, comfortable, and matter-of-fact. Try asking them about their feelings in the same way you might ask about a recent physical illness.
• Be prepared to share information about how depression can affect children and families. Share how depression can get in the way of caregiver-child relationships. When caregivers have strong coping skills, they are better able to pay attention to and spend quality time with their children. They can show their children how to manage their feelings in a healthy way.

Here are some ideas to start the conversation:

• “Is now a good time to talk and check in?”
• “How are you feeling?”
• “Can you tell me more about _____________ (something they said that might be a sign of depression, like “... when you said you felt empty or numb inside”)?
• “How can I help you?”
• “Can you tell me more about how you are feeling now?”
• “It is common to have surprising new thoughts after a big change or event. Have you had any new or different thoughts lately?”

Prepare for Common Responses

Starting a conversation with a family member about depression is an important first step. Be prepared for their response. They may have many different reactions to questions about mental health including anger, frustration, relief, sadness, appreciation for your concern, worry, or anxiety.

• They may not be ready for or interested in receiving therapy or acknowledging their feelings of depression. Respect their position. Help them understand other ways to improve adult and child wellness at home. Strategies include setting up or keeping up family routines and rituals, hanging out with family and friends, and building healthy habits like dental care and exercise.
• For most people, it takes time to decide to get help. Keep the conversation going by creating an open environment where families know they can ask for help. Families are more likely to continue sharing honestly if staff respect their opinions and reactions, and they are more likely to ask for help when they feel ready to take a step toward treatment.
• When a family member is ready to seek help, program staff should be prepared to help them by making an appropriate referral. Learn more about what they are looking for in a provider and make the referral as soon as possible.

What if a caregiver is in crisis and needs help right away?

Working with a family member in crisis is challenging. If you believe someone may harm themselves or their children, it is important to act right away.

Staff should:

• Always have a way of contacting an assigned supervisor, mental health consultant, or administrator for immediate guidance or support.
• Be comfortable asking direct questions such as “Are you thinking of hurting yourself? Are you thinking of hurting your child?”
• Know what to do if the answer to either of these questions is “Yes.” Programs can ensure staff know which community partners to call in times of crisis. Often this will be a clinic, hotline, or the local hospital emergency room.

Last Updated: June 28, 2024