The Society for Social Work and Research

2014 Annual Conference

January 15-19, 2014 I Grand Hyatt San Antonio I San Antonio, TX

Racial/Ethnic Differences in Minority Adolescents' Perceptions of Perinatal Depression and Mental Health Treatment

Friday, January 17, 2014: 9:00 AM
Marriott Riverwalk, Alamo Ballroom Salon F, 2nd Floor Elevator Level BR (San Antonio, TX)
* noted as presenting author
Cynthia Fraga Rizo, MSW, Doctoral Student, University of North Carolina at Chapel Hill, Chapel Hill, NC
Sarah E. Bledsoe-Mansori, PhD, MSW, MPhil, Assistant Professor, University of North Carolina at Chapel Hill, Chapel Hill, NC
Candace Killian-Farrell, LCSW, MSSW, Doctoral Student, University of North Carolina at Chapel Hill, Chapel Hill, NC
Whitney Sewell, BA, Research Assistant, Student, University of North Carolina at Chapel Hill, Chapel Hill, NC
Lydia V. Johnson, BA, Research Assistant, Student, University of North Carolina at Chapel Hill, Chapel Hill, NC
Traci Wike, PhD, Assistant Professor, Virginia Commonwealth University, Richmond, VA
Julia Wessel, MSW, Fellow, Yale University, New Haven, CT
Anne-Marie O. Bellows, MSW, Project Coordinator, University of North Carolina at Chapel Hill, Chapel Hill, NC
Background and Purpose: Approximately 20-44% of pregnant adolescents meet criteria for perinatal depression (PND; Szigethy & Ruiz, 2001; Meltzer-Brody, et al, 2012). PND is a leading cause of maternal morbidity and mortality. Moreover, PND increases risk of preterm birth, infant mortality and, enduring negative outcomes for mother, child, and family (Goldenberg, Culhane, Iams, & Romero, 2008).

Despite high prevalence, few pregnant adolescents with depression receive mental health services (Upadhya & Ellen, 2011). Low-income and racial/ethnic minority adolescents experience the greatest disparities in service use (Newacheck, Hung, Park, Brindis, & Irwin, 2003). Studies have shown that these adolescents can be engaged if service providers address their unique needs. However, diminishing disparities in the treatment and prevalence of PND in low-income, racial/ethnic minority adolescents requires a better understanding of how these adolescents perceive depression, mental health services, and barriers to accessing treatment. To begin to address the dearth of knowledge on these young women’s perceptions of their experiences, our team conducted a qualitative study exploring differences among Latina and non-Latina depressed, pregnant adolescent mothers’ perceptions of PND.

Methods: We conducted in-depth interviews with 20 pregnant, depressed adolescents recruited from two public health prenatal care clinics. Participants were primarily racial/ethnic minority adolescents (46.5% African American, 46.5% Latina); average age was 17.28 years (SD=1.49); and majority reported annual household income less than $20,000.

Interviews were part of a feasibility study testing Brief Interpersonal Psychotherapy for Adolescent Perinatal Depression and occurred before treatment. The ethnographically informed interviews were facilitated using a standardized interview guide that addressed participants’ perceptions of current problems, mood, mental health treatment history, hopes for treatment, and barriers to access mental health services.

The interviews were audiotaped, transcribed, and checked for accuracy.  Data was managed in NVivo 7. Analysis followed a descriptive qualitative approach using preexisting codes based on prior research/experience as well as emergent codes discovered using an inductive iterative process. After all data were coded, comparisons were made across Latina and African American participants for each of the study’s main themes and findings. We used multiple coders, triangulation, and negative case analysis.

Results: Although a number of similarities emerged across the Latina and African American participants’ perceptions of the problem, their depression, treatment history, needs, and barriers/promoters to treatment, we also identified some vast differences. Differenced tended to center on issues related to social network (family, friends, partners), culture, and immigration. For example, Latinas did not discuss: (a) family as promoters/barriers to treatment or (b) informal diagnosis by family/friends. Further, Latinas discussed their perceptions regarding treatment through the lens of marianismo. Detailed information about these and other differences will be presented.

Conclusions and Implications: This research takes a preliminary but important step toward understanding racial/ethnic differences in depressed, pregnant adolescents’ perceptions of their experiences. Such research is sorely needed to provide meaningful and culturally relevant services capable of engaging low-income, minority adolescents in treatment for PND. Although the findings from this qualitative study are not generalizable, the results provide important information about this population and identify areas for future research.