1. Dr. Ellen Lipman, P.I. Heather Whitty, Project Coordinator

2. 1. What we know about young mother mental health? 2. The Young Mothers Health Study protocols 3. Results to date

3.  Teen pregnancies account for 3.6% of pregnancies in Ontario and 4.7% in Hamilton  Young mothers are at risk of mental health problems (including depression, anxiety and substance dependence) and socioeconomic challenges  Children of young mothers are at risk of preterm birth and low birth weight, and display more behavioural problems, academic underachievement, substance abuse, involvement in crime and mental health problems later in life

4.  Young mothers (N=450) invited to complete questionnaires about mental health, health and mental health service utilization and demographic information

5. Target Sample (N=450) ◦ 15-20 year old females ◦ Pregnant with child (they intend to carry to term) or recently gave birth to child (baby is no older than 24 months) ◦ Child does not have to be in care of mother ◦ Focus is Hamilton, but will accept moms from other nearby regions ◦ English speakers  Comparison Groups (N=~110 per group) ◦ 15-20 year old non- pregnant females ◦ Pregnant with first child or recently gave birth to first child AND over 21 years old

6.  Young Parents Network ◦ Grace Haven ◦ St. Martin’s Manor ◦ Angela’s Place  Hamilton Public Health Services ◦ Nurse-Family Partnership ◦ Canadian Prenatal Nutrition Program ◦ Healthy Babies, Healthy Children  Hamilton Midwives, Community Midwives, Access Midwives  LEAP  Hamilton Health Sciences ◦ Adolescent Medicine  St. Joe’s Hospital ◦ Women & Infants’ Program ◦ Women’s Health Concerns Clinic  Shelter Health Network  The Living Rock  Catholic Children’s Aid Society  Hamilton Regional Indian Centre  Hamilton-Wentworth District School Board

7.  Mothers are contacted 2-3 months after birth (for mothers recruited prenatally)  Mothers are contacted as soon as possible for mothers recruited postpartum  Interview takes about an hour  Interviewer travels to participant at time and place convenient to participant OR conducted through telephone interview

8.  $45 gift card to young mothers  $20 gift card to mature mothers and young women

9.  Participants are assigned an identification code  No names will ever be published

10.  No anticipated risks with this project  Benefits include information about resources, opportunity to “tell their story”  Long-term benefits include development of appropriate, accessible mental health services

11.  Recruitment  Participant Characteristics  Selected Mental Health Problems Endorsed by Participants  Note: Study is currently in-progress, therefore results are not final

13. Young Moms N=140 Mature Moms N=52 Young Women N=32 Age 15 16 17 18 19 20 21 Mean (range) 3 4 26 31 34 41 1 18.5 (15-21) N/A 4 27.8 (21-38) 3 1 7 14 6 0 18.4 (15-20) High School Graduates No Yes % of HS Grads 97 43 30.7% 1 51 98.0% 10 22 68.8% Highest education complete Grade 8 9 10 11 12 Mean (range) 11 13 34 39 43 Gr 10 (Gr 9-12) 0 1 51 Gr 12 (Gr 11-12) 0 4 1 4 23 Gr 12 (Gr 9-12)

14. Young Moms N=140 Mature Moms N=52 Young Women N=32 Highest Degree No Postsecondary Trade / Diploma Community College Bachelor’s Master’s PhD In-progress diploma In-progress bachelor’s 131 1 2 0 4 2 11 1 15 8 1 0 1 12 0 20 Income, Personal Mean (range) Don’t know Missing 11178 (0-62740) 3 2 28811 (1060-85000) 0 2 25560 (0-6963) 1 0 Income, Household Mean (range) Don’t know Missing 30030 (384-212740) 46 2 65876.15 (13200-132428) 9 2 140750 (10172-308500) 14 3

15. Young Moms (n=140) n(%) Mature Moms (n=52) n(%) Young Women (n=32) n(%) Major depressive episode, current 31 (22.1)4 (7.7)6 (18.8) Major depressive episode, past73 (52.1)18 (34.6)12 (37.5) Manic episode, current11 (7.9)1 (1.9)1 (3.1) Manic episode, past23 (16.4)8 (15.4)1 (3.1) Hypomanic episode, past44 (31.4)12 (23.1)12 (37.5) Generalized Anxiety Disorder, current 15 (10.7)1 (1.9)*2 (6.3) * data missing (n=1 )

16. Young Moms (n=140) n(%) Mature Moms (n=52) n(%) Young Women (n=32) n(%) Panic disorder without Agoraphobia, current 1 (0.7)1 (1.9)1 (3.1) Panic disorder with Agoraphobia, current 14 (10.0)1 (1.9)2 (6.3) Agoraphobia, without history panic disorder current 69 (49.3)8 (15.4)6 (18.8) Separation Anxiety Disorder, current19 (13.6)01 (3.1) Social Phobia, current30 (21.4)5 (9.6)6 (18.8) Specific Phobia, current 48 (34.3)11 (21.2)6 (18.8) OCD, current34 (24.3)9 (17.3)6 (18.8) PTSD, current31 (22.1)03 (9.4)

17. Young Moms (n=140) n(%) Mature Moms (n=52) n(%) Young Women (n=32) n(%) Alcohol Dependence, current15 (10.7)2 (3.8)6 (18.8) Alcohol Abuse, current8 (5.7)00 Substance Dependence, current17 (12.1)2 (3.8)5 (15.6) Substance Abuse, current9 (6.4)1 (1.9)0 Tourette’s Disorder/motor current/vocal 000 Psychotic Disorder, lifetime12 (8.6)1 (1.9)*0 Psychotic Disorder, current8 (5.7)0*1 (3.1) * data missing (n=1 )

18. Young Moms (n=140) n(%) Mature Moms (n=52) n(%) Young Women (n=32) n(%) ADHD Combined, current15 (10.7)1 (1.9)0 ADHD Inattentive, current6 (4.3)1 (1.9)0 ADHD Hyperactive/Impulsive, current8 (5.7)01 (3.1) Conduct Disorder, current20 (14.3)01 (3.1) Oppositional Defiant Disorder25 (17.9)5 (9.6)2 (6.3) Average total disorders (range)4.9 (0-15)2.2 (0-10)2.8 (0-9) Average current disorders (range)3.4 (0-12)1.1 (0-7)1.8 (0-7)

19.  Young mothers participating in the study endorse multiple psychiatric disorders, and a range of disorders; comparison women endorse fewer disorders  Young mothers participating in the study are disadvantaged in terms of education and income

20. 1. Select young women (N=30) will be invited to participate in qualitative interviews to explore and understand their mental health service use 2. Select young women (N=50) will be invited to complete questionnaires about parenting and child development 3. Interview service providers and policy makers about the perceived service needs and adequacy of services for young mothers.

21.  We need more young moms to interview!  Provide information about our study ◦ Display flyer in high traffic areas of your facility ◦ Talk about the study, answer questions ◦ Hand out study brochure  Use the Consent to be Contacted form ◦ Project coordinator will initiate contact with if you collect participant contact information and fax form ◦ Removes the onus of initiating contact from mother, who can be busy and may overlook the brochure

22. Dr. Ellen Lipman Primary Investigator 905-521-2100 ext. 77359 lipmane@mcmaster.ca lipmane@mcmaster.ca Heather Whitty Project Coordinator 905-521-2100 ext. 74349 Text: 905-869-4349 Fax: 905-574-6665 hwhitty@mcmaster.ca hwhitty@mcmaster.ca Questions?