Project Summary Postpartum depression (PPD) is a significant mental health and public health problem. It is estimated that 10-15% of women suffer from major depression after childbirth. Considerable research has shown the negative impact of maternal depression on children and mother-child relationships. Mothers living in poverty are more likely to be depressed and have greater difficulty accessing mental health service, and therefore are a particularly vulnerable group. A variety of personal, practical, and organizational barriers hinder postpartum mothers from utilizing available mental health treatment. A community based participatory research approach is a promising strategy for developing and implementing services research addressing barriers to mental health utilization for low-income, depressed, postpartum women because it brings together the expertise from the community and academia. This application proposes strengthening a partnership between the Children's Hospital of Philadelphia/University of Pennsylvania, Maternity Care Coalition (MCC), and community members. This partnership will foster collaborative mental health services research for postpartum women and their families. It will also involve improving MCC's research capacity, convening a community advisory board, and planning for sustainability and dissemination. The research plan involves designing a referral intervention to facilitate successful referrals to mental health treatment that will be tested in open trial for feasibility and acceptability. The referral intervention will be manualized and consist of strategies and modules (e.g., psychoeducation, problem solving, follow-up) to facilitate mental health utilization. This pilot work will be used as a foundation for a R01 application to conduct a randomized trial in this community comparing the referral intervention to routine referral strategies. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE This project proposes strengthening a community-academic partnership to address access to mental health treatment by postpartum, low-income, depressed women. We will build the research capacity of the community organization and collaborate in developing and providing a preliminary test of a brief referral intervention that focuses on personal and organizational barriers that keep depressed postpartum women from accessing mental health services. Given the prevalence of depression in mothers, its impact on children and costs to society, the development of empirically based strategies to increase mental health use will be an important contribution to improving maternal and child outcomes.