Long-term disparities and mediators of psychological distress in mothers with and without out-of-home care experience: analysis of prospective cohort data
Jeongeun Park, Rachel M Hiller, Katherine Shelton, Bethan Carter, Eva A Sprecher, Erin Mckeaveney, Jeri L Damman, Charlotte Robinson, Tara Ramsay-Patel, Lisa HolmesObjectives
Care-experienced individuals are at elevated risk of mental health difficulties, yet less is known about their mental health needs in motherhood. This study aims to explore (a) disparities in trajectories of psychological distress in care-experienced versus non-care-experienced mothers as they raise their child from age 3 to 14, and (b) putative postpartum-associated pathways shaping disparities in maternal distress at child age 14.
Design and setting
We conducted longitudinal secondary data analysis using the prospective United Kingdom Millennium Cohort Study data.
Participants
11 252 mothers and their children were included in the analysis, including mothers who experienced out-of-home care in their childhood (N=156).
Outcomes
The primary outcomes were psychological distress of mothers at child ages 3, 5, 7, 11 and 14.
Results
Relative to non-care-experienced mothers, care-experienced mothers were consistently more likely to experience distress across child ages 3–14 (coefficient (B)=1.36 (95% CI 0.85 to 1.87) p <0.001). The association between maternal care experience and increased maternal distress in their child’s adolescence was mediated by mental health difficulties (B=0.57 (95% CI 0.18 to 0.96) p =0.005), lower locus of control (B=0.31 (95% CI 0.11 to 0.51) p =0.002), lower income (B=0.28 (95% CI 0.15 to 0.41) p <0.001) and lower social support (B=0.16 (95% CI 0.05 to 0.28) p =0.006) in their child’s infancy.
Conclusions
Our evidence underscores the potential value of holistically considering postpartum mental health, psychosocial and financial resources in maternal and early childhood public health interventions to disrupt the cumulative inequity likely faced by care-experienced mothers and prevent their mental ill-health in the long term.