Examining Mental Health Illness in a Community Based Sample of Pregnant and Postpartum Youth: A Pilot Study

Abstract

Background: One in five women will suffer from mental health (MH) disorders during their pregnancy or first year postpartum. These rates are even higher in adolescent mothers. In an attempt to optimize health outcomes for young mothers and their families, a multi-disciplinary clinic for pregnant and post-partum adolescents was established at a community based young parent’s outreach center in Ottawa in 2004 (St. Mary’s Home). An on-site psychiatric clinic was piloted at the center in 2013. The current study aimed to describe characteristics of patients using data obtained at initial assessment. Methods: A total of 36 patients were referred over the recruitment timeframe, of which 28 attended the first assessment and consented to participate. The patients completed a battery of psychological measures and assessment tools which screened for issues relating to mood, anxiety, attachment, level of functioning and distress, substance use, and coping skills. Our institution’s research ethics board approved the study. Results: Thirty nine percent of those assessed were adolescents (<18 years). The mean age of all participants was 19.4 years (+/-2.3 years). Just over 80% (82%) of assessments were initiated in the antenatal period. Approximately 1/5 of patients were rated as having severe mental health problems at intake when the Threshold Assessment Grid (TAG) was applied. Over 80% (82.1%) of the sample demonstrated moderate to severe levels of depression on the Edinburgh Postnatal Depression Scale (EPDS) and half of all participants reported anxiety levels in the moderate to severe level. In addition, the majority of participants experienced insecure anxiety-based and avoidance-based attachments with close relationships and low scores on measures of infant-attachment. At least 10% of the sample endorsed other symptoms that would suggest other possible mental health diagnoses, including drug and alcohol abuse (11% each) and panic syndrome (43%). Conclusions: Assessed patients demonstrated high rates of psychiatric morbidity and distress as evident by clinical scores on a number of different measures. It is vital that any program that offers care to pregnant and postpartum youth have sufficient resources to address these issues in order to help optimize overall health outcomes.