Caring for young children is tough work, full of stressors and challenges that even the best equipped parents struggle with. Young mothers with a history of being abused or neglected as children must cope with their trauma, the uncertainties of young adulthood and the constant demands inherent in caring for small children.
A new study led by Dr. Elizabeth Aparicio, assistant professor of behavioral and community health in the UMD School of PUblic Health, focused on understanding the unique parenting and mental health needs of young moms who experienced abuse or neglect in their own upbringing. Aparicio’s work focuses on how to interrupt intergenerational cycles of violence and trauma and prevent child abuse.
The study, published in the Journal of Family Violence, is based on interviews with young mothers (18-25) in Maryland and Washington, DC who had one or more children by the time they were 19 years old, as well as professionals serving them and some of the mothers’ own caregivers. Aparicio and colleagues partnered with the organization Hearts and Homes for Youth to conduct this community-engaged research and analyze the data using a method called grounded theory, which allowed them to characterize how maltreated mothers access and receive mental health and parenting support.
“These moms have experienced child abuse and neglect themselves but they are young and full of energy and optimistic about wanting to change the trajectory of their families” Aparicio explained. “From a prevention standpoint, they are usually really motivated to access services, but from the system side, we need to make sure that they can access all the supports they need. Most interventions address parenting and mental health needs separately, although we know that they are intertwined and should be integrated together.”
With a background in social work, Aparicio understands the seemingly insurmountable barriers young moms face - from their own mental health struggles and need for safety from abusers, internalized stigma, the competing priorities of caring for their kid’s and their own needs, challenges in accessing therapy or substance abuse treatment, as well as ongoing concerns about affording and accessing transportation, education/employment, food, housing and child care.
Most interventions address parenting and mental health needs separately, although we know that they are intertwined and should be integrated together.
Aparicio cites two examples of programs that provide a model for what is sometimes called “wraparound” support that provides integrated and comprehensive care. The Hearts and Homes for Youth program and the Children’s Hospital's Healthy Generations program both include comprehensive services from access to medical and mental health care, legal referrals, parenting classes, diapers and healthy food, among others.
Previous research has shown that children born to young parents are at elevated risk of abuse and neglect and that about a third of people with a history of childhood maltreatment, including physical or sexual abuse or neglect, will go on to abuse or neglect their children.
Aparicio says that people often experience multiple types of child abuse and neglect in combination.
“These are all things that could individually affect a person, but the cumulative effect can be really a lot to cope with, so having systems that are ready and available to provide trauma-informed care is super important so that people can grow and heal from those experiences,” she explained.
Through the interviews, Aparicio and team looked at how young moms reckoned with their trauma and accessed and received mental health and parenting support.
Because of their young age, some of these mothers are still experiencing trauma and abuse from their own parents and not in control of what their children are exposed to daily. A 22 year old mom whose father spit at her and smacked her in front of her child shared:
“I cannot wait to get away from this man. Like, this is not what I want my child to see, to feel.”
Health care professionals expressed frustration in not being able to find the resources the young moms need.
“I’m a social worker and I have trouble finding parenting classes that these kids can go to,” one interviewee said.
Others talked about the frustration with wait times for referrals for substance use treatment. “You have to be ready to go the day they are ready to go,” Aparicio said. “Some social workers who worked on a specialized unit who would be called in to help when a mom who was actively using drugs gave birth shared that the mom wanted treatment to stop using, but couldn’t receive treatment.”
In addition to waitlists, referral challenges and changing providers, young moms often lacked trust in therapists and mental health care systems because of negative past experiences.
Aparicio and colleagues urge that referral and intake processes be made as simple as possible to reduce barriers to engagement. She also says that they found that having young moms connect with other moms who could be mentors and could normalize this phase of life as challenging –the combination of adolescence, young adulthood and parenting young children –was very important.
“Our study found that it is really important for us to be addressing parenting and mental health together,” Aparicio said. “There are really great evidence-based parenting programs and really great evidence-based programs for mental health, and these could be integrated. Our next step is to test an integrated approach and the impact that can have.”