Pregnant Teens with Mental Illnesses Need Health Care and Support
In a study published in 2009, University of Colorado researchers looked at the relationship between teenage pregnancy and psychological distress. At the time, much attention had been given to the high rates of depression among teenage mothers (another study showed that teenage fathers also had higher incidences of depression). The study found that teenage mothers had higher levels of distress than childless peers or adult mothers. A surprising finding, however, was that for these teenagers being pregnant or having a child wasn’t the cause of the depression.
A study released this week may have found the answer as to why.
Researchers examined live birth rates among teens aged 15-19 in Ontario, Canada covering a ten year period from 1999-2009. Among the 4.5 million girls, they looked at those with and without a major mental illness. While teen birth rates had declined steadily during the ten year period, pregnancy rates among girls with diagnosed mental illnesses such as bi-polar disorder, schizophrenia, and major depression declined at a much slower pace than those without a disorder. More surprisingly, these girls were three times more likely to become pregnant than girls without a mental illness.
Though the study looked only at girls in Ontario, as the University of Colorado study shows, similar results would more than likely occur in the United States.
Neither study looked into causal relationships, though it’s not too difficult to understand that the stress of being a teenager coupled with having a child is bound to increase pressure on everyone involved. Previous studies have shown that vulnerable populations are at a higher risk for teen pregnancy. Poverty, sexual abuse and living in a home with domestic violence all increase the chances of teenage pregnancy. These are all stressors which can lead to, or exacerbate already existing, mental health issues.
These are also the same groups that are most likely to not have access to mental health care.
Overall teen pregnancy rates have declined dramatically over the past 20 years, with black and Latino teens having the highest rates of teen pregnancy. There has been a great deal of research showing the racial and ethnic disparities in health care overall in these communities, and the disparity in diagnosis and treatment of mental health is even more profound. Aside from the cultural stigma associated with mental illness, inherent racial bias within medical, psychological and social services prevent many from accessing the care they need.
Much of the decline in teen pregnancy can be attributed to an increase of sex education and contraceptive use. The study suggests, however, that not enough is being done to address the self-esteem issues that are associated with many illnesses, such as depression. For example, a girl may understand the need for birth control and even how to use it, yet lack the assertiveness to obtain it or have her partner use it. Furthermore, many with undiagnosed issues often use drugs or alcohol to cope, leading to an increase in impulsive behaviors already associated with illnesses such as bi-polar disorder.
The findings are also important considering the aftermath of teen pregnancy. Teen mothers are already at a higher risk for postpartum depression. Understanding that she may already have a preexisting issue means steps can be taken during pre and post natal care to ensure a healthier transition into motherhood. This can make a great deal of difference for her as she goes into adulthood and, more importantly, help reduce the negative impact on her child.
The researchers suggest that major public and clinical policy changes need to occur in light of these findings. The design and implementation of pregnancy prevention programs need to include major mental illness diagnosis and treatment. Identifying risk factors which include mental illness can not only help the well being of mother and child, but also go a long way in further reducing teen pregnancy overall.