Pediatric professionals may naturally view themselves as gatekeepers or facilitators of access to mental health services for children, but may not see themselves as the first line of "defense" for parents with mental health issues. However, about two thirds of women who meet criteria for affective disorders, and slightly more than half of the men who do, are parents. Given that the average age of onset for affective disorders is several years after the birth of first children, parental depression may initially come to the attention of pediatric providers, the most likely professionals with whom parents have contact prior to children starting school. The health and well-being of parents and children are intimately intertwined. Simple screening, education, and support strategies for parents and referral to specialty services, when appropriate, have the potential for positive impact on all family members.