parents and their children. These challenges include a lack of or inadequate insurance coverage, reimbursement practices and policies that are inconsistent with the research base, and a lack of funding streams to pay for two-generation, research-informed prevention and parenting interventions as well as early interventions for children.

This chapter provides an overview of the policy environments that can resolve systemic, workforce, and fiscal policy challenges associated with implementing innovative and research-informed practices to improve outcomes for depressed parents and their children. It concludes by highlighting policy recommendations that support bolder federal and state responses to the problem of parental depression.

Three broad issues must be addressed to create a more responsive policy framework to increase access to research-based prevention, screening, and treatment through a family-focused lens for those coping with parental depression: (1) systemic barriers, (2) workforce capacity and competence, and (3) fiscal barriers.

Building a comprehensive policy and service response to parental depression that includes attention to impacts on adults, on children (especially young children), and on parent-child relationships, as described in Chapter 8, requires refocusing program strategies through a family lens. Right now, few, if any, policy models exist for delivering family-focused mental health services. Systemic barriers across health, mental health, and other systems will have to be overcome to provide the range and intensity of researchinformed prevention, treatment, and parenting support services discussed in this report.

Below we highlight four of the most important systemic policy and services frameworks challenges to overcome to implement these strategies:

1. creating a two-generation response to parental depression;

2. responding to the needs of vulnerable populations, particularly low-income and culturally and ethnically diverse families;

3. responding to families experiencing depression along with other comorbidities and family adversities; and

4. developing complex interventions that build on collaborative, integrated, and comprehensive service models.