Learning from Teen Parents to Improve Postpartum Depression Screening and Treatment
Parents throughout the country are facing significant psychological stressors that have only been exacerbated by the COVID-19 pandemic, and these stressors can contribute to new or increased symptoms of mental health conditions. For parents, mental health conditions occurring in the period surrounding the birth of a child, known as Perinatal Mood and Anxiety Disorders (PMAD), can be particularly challenging to cope with. Adolescents transitioning to parenthood are even more susceptible to these conditions, but they are often overlooked in the design of perinatal mental health services.
Through a Stoneleigh Emerging Leader Fellowship, our team at PolicyLab has devoted time and resources over the last two years to further explore how to support and address the specific mental health needs of parenting adolescents. We wanted to hear directly from young parents about their experiences navigating the behavioral health system and feelings after giving birth, so we spoke to several new parents in our community as part of our project.
What these parents told us reminds us that addressing perinatal mental health, especially among adolescent parents, is more important than ever.
Concerns Among Parenting Teens
We conducted interviews with young mothers ages 15-19 who were screened for postpartum depression (PPD) at their infant’s well-child visit at a Children’s Hospital of Philadelphia (CHOP) Primary Care Clinic. As we spoke to these mothers, key themes emerged based on what they were kind enough to share with us, several of which are highlighted below:
Participants expressed uncertainty as they entered into a brand new chapter of their lives. The fear of starting parenthood was salient throughout many discussions.
“I was scared about just being a parent, because it's easy to fail."
Awareness of a condition and being prepared for the experience were not always synonymous. Even when participants knew that PPD is common among people who give birth, they were still faced with an onslaught of overwhelming emotions and symptoms.
“People told me that I might have postpartum, but I always kept a positive mind. I was sure I was gonna be happy and ready to do this, to be a mom and all that. I was ready. It was just everything came on me. It was a lot.”
Many participants had moments of revelation during our interviews and discussions. They found themselves engaging in honest conversations, not just with facilitators, but with themselves about what services and resources would help them postpartum.
“There's so much I don't even understand. I know I need therapy. I know.”
Some participants also wished they had more support and follow up in getting connected to mental health care.
“I don't want to feel sad towards my baby. I want her to feel happy. I want her to know that her mom was happy. I'm happy that they talked to me and I was prescribed some medicine… It's probably not their fault but I wished they tried with...questioning a little bit more to talk to a therapist.”
Supporting Parents Through Healthy Mind, Healthy Kids
As we gained insights from speaking with young moms and lessons learned from key informant interviews, it became clear that there was an opportunity within CHOP to innovate and help close the gap between screening and treatment for adolescent parents. We partnered with CHOP’s Healthy Minds, Healthy Kids, an integrated behavioral health care program, to train clinicians in perinatal mental health and provide support to postpartum adolescent parents experiencing mental health concerns. Through this partnership, we hope to understand if providers can use specialized integrated behavioral health care to meet the needs of adolescent parents with or at risk of PMAD.
Ultimately, the creation, implementation, and analysis of these projects reflects the urgent need to address major health care deficits and poor patient advocacy experienced by this population.
As the Fellowship project wraps up, we transition from learning to action. Speaking with clinicians and young parents, we uncovered vast inequities and gaps in care for those who need it most. Moving forward—particularly as we recognize National Family Caregivers Month—we will build off our recommendations for researchers, health care providers, payers and policymakers to improve access to mental health care for parenting teens.
We will continue to push systems to invest in programs and policies that center the voices of those with lived experience, incentivize the development of trusting relationships between service providers and recipients, and seek innovation in implementing and transforming existing care models to better meet the needs of adolescent parents.
Oluwademilade (Demi) Adefarati is a graduate student researcher contributing to a Stoneleigh Emerging Leader Fellowship project. Demi is currently a second year Master of Public Health candidate at Drexel University Dornsife School of Public Health, majoring in Health Management & Policy.