Case Study: Marie, A Pregnant 17-Year-Old Latina Facing Homelessness, Substance Use, and Mental Heal

Marie is a 17 year old Latino female. She is the second to oldest child of a family of 6 children – Juan (21), Mary (12), Myria (10), Hosea (5) and Antonio (3). She currently lives with her mother, Louisa (36) and her grandmother, Rosa (53). She has not had any contact with her father, Carlos (38) since she was 2.

Louisa recently lost her job, and the family received an eviction notice earlier this week. Her oldest brother Juan is currently in prison for drug related offenses. Her grandmother does not work due to a medical nerve condition and diabetes that has advanced to the point that she is unable to walk for long periods of time. Marie has no extended family or support networks in the area. The family has no insurance or transportation since Marie’s mom recently sold the van to help pay last month’s rent. The family is about to be out on the street.
Marie is currently 3 months pregnant with her first child. Marie is no longer in contact with the father of her baby and states that “he was a loser anyway.” She is a junior in high school and is contemplating dropping out because of the pregnancy. She has a 1.5 grade point average at this point and has gotten in trouble several times for skipping school.

No one in her family has ever graduated from high school. Since moving to the states when Marie was 2, her mother and grandmother continues to struggle with the English language. The family is devout Catholic and goes to Mass every weekend. A friend suggested that Marie get an abortion, but Marie was adamant that it was against her beliefs. She has not had any medical appointments for the baby at this point, and says that she cannot get help because she does not have insurance. She is unsure how she will support the baby, especially now that her mother is no longer employed. Marie has limited vocational experience; she worked at McDonalds for a short period of time until “they drove me crazy, and I had to cuss them out.” At this point, she is expecting that her mom and grandmother will support her.

In regards to substance use, Marie admits that she “smokes a few joints and has some mixed drinks” to relax in the past. She is hesitant to discuss any current drug/alcohol use. She admits that she was “drunk” when she conceived her baby. She talks about having access to “anything she wants” because of the activities of her brother. She says she had “tried” some cocaine and heroin in the past. She still associates with her brother’s peer group who has been known to have gang affiliation. Marie says that she does not have a “best friend” but has several “acquaintances.” She got in several physical fights this year at school and had the police come out to their apartment earlier this year resulting in an assault charge for a physical altercation with her neighbor.

Marie admits that she’s had thoughts of killing herself. She took a handful of Tylenol and her grandmother’s pain medication last year in an attempt to end her life. She has scars on both of her arms where she says she just cuts to feel normal. She says it is no big deal and that everyone is doing it. Her mother has taken all of the razors out of the house, but Marie says she just finds something else to use. The family has no known mental health disorders, although her mother reports of a “crazy aunt” who had mood swings and her own father who “drank himself to death.”