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As I look towards the 21st century I see three challenges that I believe APPPAH needs to meet in order to grow as an association and to effect positive change in the world. These challenges have to do with our relationships to our communities, to institutions and to the academic world. First and foremost, I would like for us to become more helpful to new parents, by translating our ideas and our ideals into practices that lead to a sharp decline in the incidence of child abuse and neglect and eventually, to a corresponding decline in alcoholism, drug addiction and violence.
This is not as difficult as it sounds. We do not need to reinvent the wheel. Many successful programs already exist that provide comprehensive screening and support for expectant and new mothers. Most of these programs adhere to one of two models.
The first is the Hawaiian system called Healthy Start. It was inaugurated on the island of Oahu in 1985 and since then has spread to all of Hawaii's seven main islands. The program, funded by the state government, screens hospital records of new mothers to identify risk factors. The procedure is simple and straightforward. Risk factors are rated 0 to 10, if a mother scores between 29 and 40 she is encouraged to accept regular home visits by a nurse or paraprofessional. If the mother scores over 40 and refuses help from Healthy Start, child protection authorities are notified.
The 15 risk factors relating to the mother are:
* She is single, separated or divorced.
* Her partner is unemployed.
* Her income is inadequate.
* She has no permanent address.
* She has no telephone.
* She has less than 12 years of education.
* She has no immediate family members who she can call for support.
* She has a history of substance abuse.
* She had late or no prenatal care.
* She has had an abortion in the last 12 months or has had two or more during her lifetime.
* She sought an abortion for the present pregnancy.
* She has previous or current involvement with child protective services.
* She has received or is currently receiving psychiatric care.
* She is suffering from depression or has in the past.
* She investigated giving up the baby for adoption.
Where assistance is indicated, the home visitor does everything from helping the mother obtain baby supplies and subsidized housing, to promoting a loving mother-infant bond by teaching the new parent how to play with her child. The home visitor is on 24 hour call for the mothers for the first six months.
Healthy Start has achieved an almost unbelievable success rate in preventing child abuse and neglect-99 per cent. It has also been confirmed as vastly improving parent-child relationships and spotting children's medical or emotional problems early.
The other model, is Parenting Place which began in 1983, when Robert McFarland, M.D, and a few of his colleagues began meeting in Boulder, Colorado after a mother and her boyfriend murdered her son and the community wanted to do something. The group decided to support the Mental Health Center of Boulder County in a grant request from the County Commissioners to begin The Community Infant Project. The grant led to the opening of The Community Parenting Center in October 1984. A few years ago the name was changed to the more welcoming and simpler Parenting Place. This center's budget has grown from $6,000 the first year to almost $100,000 in 1996. The Center has one full time director, one part time office manager and 15-20 regular volunteers.
1. The center provides:
* Prenatal and post natal services
* Outreach to new mothers
* Parenting discussion groups
* Baby massage sessions
* Single mother help
* Fathering courses
* Puppet shows
* How to discipline without hitting
* Psychotherapy referrals
* Play groups for parents and toddlers and for other age groups.
* Music groups
* Pregnancy support group
* Home visits
* North Boulder La Leche League
* Lectures on health, nutrition, sex after childbirth
* Pot lucks
* Mom's Night Out
* New Parents Directory to mothers in the hospital that lists many of the facilities offered in the community.
* Monthly newsletter that offers advice and support for new parents.
2. A forum for people interested in details of such programs. They also started a new page on the Internet under the title: Internet Parenting Community Network.
3. Parties and Fund Raisers
* Mardi Gras party
* Santa's House
* Celebration of Community
* Grant requests are submitted regularly to various local agencies, the city, the county and the state governments.
4. Liaison with other community groups such as:
* Leave No Child Behind
* Teen Parenting Advisory Council
* Week of the Young Child
* Interact Advisory Council for Developmentally Disabled Children
* Human Service Alliance, which includes most nonprofit advocacy groups in Boulder.
The cost is minimal. All these services are provided on a shoestring budget, mainly by \"graduates\" of the programs. The Center charges a $2.00 fee for most programs or a $50.00 yearly membership fee.
The results are remarkable. Child abuse as measured by physical and sexual abuse reports, hospital records of injuries and follow-up studies has been virtually eliminated in the areas serviced by this and others similar centers. All of these programs have been written up. The scientific literature is readily available. Information about these programs is also easily accessible on the Internet. What I hope, what I dearly wish, is that some stout hearted men and women amongst you will respond to this challenge by either joining an existing support program for new parents or starting one of your own. Should you contemplate doing so, please feel free to contact me.
In a similar vein, Dr. Ludwig Janus was too modest to tell you that he, together with Terrence Dowling, an old friend of APPPAH, has started a private hospital close to Heidelberg. Here, as part of the intensive psychotherapy treatment, specific prenatal and perinatal oriented therapy will be offered. I think this marks a major advance in raising the public's as well as the medical profession's awareness of the significant contributions that Pre- and Perinatal Psychology is making to the field of Psychology and Psychotherapy. Dr. Janus deserves our warmest congratulations for this remarkable achievement. So, here is a second area, that of private and public hospitals and other treatment facilities, in which I hope more of our members will participate.
Finally, we have been slow in advancing our case with the academic community. Therefore, I am doubly pleased to tell you that a breakthrough in this respect is imminent. I have been asked by St. Mary's University of Minneapolis, Minnesota to inaugurate in the fall of 1998 a one year certificate program at the postgraduate level in Prenatal And Perinatal Human Development. This program represents the first such offering at an accredited university and we hope it will serve as a model to be replicated by other institutions of higher learning.
I ask you to share your skills, your knowledge, your passion for the welfare of future generations and your communities in tangible, down to earth, effective ways. Each one of us can make a difference. Acting together, God knows what we can accomplish. Let's find out. Let's do it!
Thomas R. Verny, M.D.
This article is an excerpt from the opening address of APPPAH founder, Dr. Thomas R. Verny, at the 8th International Congress of APPPAH, Dec. 4, 1997 in San Francisco. Direct correspondence to 38 Madison Avenue, Toronto, Ontario, Canada M5R 251.