U.S. moms and dads have a mental health crisis

Parents are increasingly on a hamster wheel of stress and guilt and more stress, according to a new advisory on parental stress and mental health issued this week by the U.S. surgeon general.

There is a clear bidirectional relationship between parental mental health and the outcomes that children experience, per the notice.

Dr. Vivek Murthy’s advisory notes the importance of reducing parental stress and protecting their mental health. It calls for “thoughtful policy changes and expanded community programs” to help parents meet challenges, including those that provide time off to care for a child who’s sick, affordable child care, access to “reliable mental health care” and other tools that “support social connection and community.”

An advisory, according to the definition included in this one, “is a public statement that calls the American people’s attention to an urgent public health issue and provides recommendations for how it should be addressed. Advisories are reserved for significant public health challenges that require the nation’s immediate awareness and action.”

Murthy, who calls raising children “sacred work,” writes that “as technological and economic forces have reshaped the world at a dizzying pace, it has also become harder for parents to prepare children for a future that is difficult to understand or predict.” Parents want their kids to be happy and successful, but they worry they won’t be able to give their kids what they need — “from safe neighborhoods to admission to the right schools to stable housing.”

The more they think their efforts fall short, the bigger the scramble to try to get it right, he said.

In his conversations with parents and caregivers, “I have found guilt and shame have become pervasive, often leading them to hide their struggles, which perpetuates a vicious cycle where stress leads to guilt which leads to more stress,” Murthy reports.

“As a father of two young children, I know the joys of parenting — but I also know the stress, loneliness & uncertainty of parentings in a rapidly changing world,” Murthy posted on X. And in an outline of the advisory for The New York Times , he said that “parents are at their wits’ end. We can do better.”

What parents face

About 63 million parents live with minor children in the U.S., in addition to other adults who have the main responsibility for caring for children, the advisory notes.

Among parental challenges:

• In 2023, 33% of parents reported high levels of stress in the past month, compared to 20% of other adults.
• Forty-one percent of parents reported that most days “they are so stressed they cannot function.” The report notes that stress was already high before the pandemic, which piled on even more stress.
• Financial worries are substantial; 66% of parents say they are “consumed by worry” over money, compared to 39% of other adults.
• One in four parents report times in the past year when they could not afford to meet basic needs. The report notes a significant association between food insecurity and symptoms of parental depression, anxiety and stress.
• Work hours and time spent on primary child care have both increased, creating a time crunch. Primary child care includes physical care, education-related activities, reading to/with kids and other activities.

Parents also contend with health issues, both their own and those of their children. In the U.S., the report says just shy of 1 in 5 children ages 0-17 have a special health care need. The most commonly reported were allergies, ADD/ADHD, behavior/conduct conditions, asthma, anxiety, learning disabilities and developmental delay.

Other issues for parents noted in the advisory were parental isolation and loneliness (65% of parents and guardians, but rises to 77% of single parents), challenges provided by children’s use of technology and social media and cultural pressures to meet societal expectations of parenting. Children’s safety is also a considerable worry for parents.

What stress can do

“Chronic or excessive stress, coupled with other complex environmental and biological factors, can increase the risk of mental health conditions for individuals,” per the advisory. It cites 2021-2022 data showing that among parents, 23.9% (20.3 million) had a mental illness and 5.7% (4.8 million) had a serious mental illness.

The report noted that women generally have a higher prevalence of mental health conditions, driven in part by postpartum depression. But the report adds that mental health in fathers has been under-studied.

Parental mental health not only affects the family directly, but increases health care costs and can reduce economic productivity, according to the advisory. Mental health impacts how parents function, how well they care for their children and whether children have adverse childhood experiences that can dog them across their lifespan.

While the impact of a parent’s mental health challenge can loom large in a child’s life, it doesn’t have to. If a child’s sense of safety, stability, support and bonding with parents and caregivers isn’t impacted, the child may not be negatively affected, per the report.

Remedying a crisis

The advisory offers a number of recommendations for policies or changes that governments at all levels can make. Among them:

• Establish national paid family and medical leave and see that workers all have paid sick time.
• Create more gathering spaces locally to cultivate social connection in communities.
• Address social and economic barriers that “contribute to the disproportionate impact of mental health conditions” for some parents and caregivers, including poverty, unsafe environments, food deserts and unaffordable housing. This also includes providing access to needed programs and supports.
• Make sure parents and caregivers can access affordable, high-quality mental health care.
• Help those who have been incarcerated get back into their communities in healthy and helpful ways.

Meanwhile, employers have a role in helping, too, per Murthy’s advisory. Besides offering flexible schedules and needed leave to deal with a medical crisis, bosses could offer child care options, the report says.

Managers should be trained on stress and work-life harmony, as well, per the report. And employers can play an important role in seeing that mental health care is available to employees.

As for communities and schools, simply making it safe to talk about parental stress and mental health is really important, as is ensuring those who need it know what’s available and how to connect.

The report also said communities and schools should “create opportunities to cultivate supportive social connections among parents and caregivers” and give them a voice in shaping programs.

Friends and family can offer practical support and connect with parents and caregivers regularly. They can also learn about mental health challenges that parents and caregivers can face, including warning signs that someone’s in crisis, per the report.

Help yourself

The final section on what to do is aimed at parents and caregivers themselves, offering a reminder that “caring for yourself is a key part of how you care for your family.” That includes getting enough sleep, being mindful, exercising, eating well and finding activities that bring joy. It’s not just OK to prioritize your own well-being, but is an essential part of caring for the family.

The advice includes nurturing connections with other parents and caregivers, making sure your family has adequate health insurance, learning about mental health and getting help in that realm if you need it.