Pregnant adolescent women’s perceptions of depression and psychiatric services in the United States

Abstract

Problem Adolescent mothers and their children are at high-risk for depression and the associated negative educational, social, health, and economic outcomes. Background However, few pregnant adolescent women with depression receive psychiatric services, especially low-income or racial/ethnic minority adolescent women. Aim This qualitative study explores perceptions of depression, psychiatric services, and barriers to accessing services in a sample of low-income, pregnant racial/ethnic minority adolescent women. Our goal was to better understand the experiences of depression during pregnancy for these vulnerable adolescent women, and thereby improve their engagement and retention in services for perinatal depression. Methods We recruited 20 pregnant adolescent women who screened positive for depression from 2 public health prenatal clinics in the southeastern United States. Participants were low-income and primarily racial/ethnic minority women between 14 and 20 years old. Data were collected through individual in-depth, ethnographically informed interviews. Findings Generally, participants lacked experience with psychiatric services and did not recognize their symptoms as depression. However, participants perceived a need for mood improvement and were interested in engaging in services that incorporated their perspective and openly addressed stigma. Discussion Participants reported practical and psychological barriers to service engagement, but identified few cultural barriers. Family perceptions of psychiatric services served as both a barrier and support. Conclusion Adolescent women are more likely to engage in psychiatric services if those services reduce practical and psychological barriers, promise relief from the symptoms perceived as most meaningful, and address underlying causes of depression. Culture may affect Latina adolescent women’s perceptions of depression and services.

The feasibility of a role for community health workers in integrated mental health care for perinatal depression: a qualitative study from Surabaya, Indonesia

“…At a practical level, there is agreement among stakeholders that a home-based approach is the best option to overcome the space limitation issue, the difficulties of accessing primigravida, and time constraints which resulted from many services being provided during an ISP activity and the unsuitability of this schedule for working mothers. This approach allows for flexible scheduling, as has been stated by CHWs and users, and is consistent with findings from another study [ 42 ].…”

No straight lines – young women’s perceptions of their mental health and wellbeing during and after pregnancy: a systematic review and meta-ethnography

“…2437 titles and abstracts were reviewed and 2389 were excluded. 48 papers were read in full and screened for inclusion – 29 of these were excluded, leaving 19 included papers [40–58]. The search process and outcome of study selection are outlined in Fig.…”

“…Fourteen studies were based in the USA, four in the UK and one in Canada and all sampled English speaking participants only. All studies aimed to report the experiences of young women with specific focus in terms of mental health and its impact on various aspects of motherhood ( n = 6) [40, 41, 45, 52, 55, 58], violence and abuse ( n = 7) [42, 43, 46, 48, 49, 53, 54], socioeconomic experiences including housing and homelessness ( n = 3) [47, 50, 51] and repeat pregnancies ( n = 1) [57]. Two studies took a more general approach around the meanings of health or the role of support [44, 56].…”

“…In terms of the study objectives, three studies explicitly stated that informing prevention of teenage pregnancy was an objective driving the research [46, 54, 57], two studies foregrounded a mental health treatment/therapy objective [45, 55] and three studies mentioned a specific policy focus [43, 50, 53]. Other objectives included helping to improve outcomes or providing better services and support for young mothers [42–44, 47, 48, 50–53, 56–58] and understanding and prioritising young women’s voices [40, 41, 43, 44, 46, 49, 52–58]. Two studies took a feminist methodology [43, 58], one took a critical psychological perspective [50], one drew on relational-cultural theory [48], two studies drew from identity and role developmental theories [40, 56] and one worked within a psychotherapeutic model [45].…”

“…Other objectives included helping to improve outcomes or providing better services and support for young mothers [42–44, 47, 48, 50–53, 56–58] and understanding and prioritising young women’s voices [40, 41, 43, 44, 46, 49, 52–58]. Two studies took a feminist methodology [43, 58], one took a critical psychological perspective [50], one drew on relational-cultural theory [48], two studies drew from identity and role developmental theories [40, 56] and one worked within a psychotherapeutic model [45]. Six studies were explicitly framed by a positive, anti-deficit view of teenage motherhood [40, 43, 44, 49, 54, 56].…”