Sickness. Loss of loved ones. Loss of child care. Unemployment. Travel restrictions. COVID antibodies in breastmilk and whether or not they offer any protection to babies. Vaccine age restrictions. Distance learning.
A LOT has been written throughout the COVID-19 pandemic about how parents (especially mothers) are not okay. Or, as sociologist Jessica Calarco succinctly put it: “Other countries have social safety nets. The U.S. has women.” As a new parent, I haven’t dealt with a fraction of what my other parent friends have gone through during the pandemic, including my essential worker parent friends, friends who were infected with COVID (along with their children), and friends juggling full-time jobs alongside remote schooling and months without consistent childcare.
Outside of think pieces and editorials, there has been a smattering of research on the mental health of parents during the pandemic in the United States. To be clear, a lot of research focuses on the indirect effects of the pandemic on parental mental health, such as institutional actions meant to curb the spread of COVID (e.g., distance learning) or behaviors stemming from attitudes about the pandemic (e.g., discrimination towards Asian Americans). This is some of the research I’m going to summarize. However, we are only beginning to understand the direct mental health effects from COVID infection, such as novel cases of psychosis in people who previously had no history of mental health concerns.1 Additionally, there are specific mental health consequences related to caring for someone with or losing a loved one from COVID.
Here are just a few studies that tell us a bit about how parents were doing during the early months of the 2020 pandemic.
Parents reported worse mental health because of the pandemic
Patrick and colleagues (2020)2 conducted a national survey of 1,011 parents (55% mothers) in June 2020 about the effects the pandemic was having on their and their children’s health. This study was pretty diverse, including 34% of parents with a high school education or less; 57% parents who identified as white (versus 11% Black, 22% Hispanic, and 10% “Other”); 81% married; and close-to-equivalent representation from various regions of the U.S. and a broad range of children ages. Overall, 27% of parents reported that their mental health had gotten worse since the start of the pandemic (rather than gotten better or stayed the same), and 14% reported that their children’s “behavioral health” had gotten worse.3 Women, unmarried parents, and parents of children younger than 12 all reported higher rates of worsening mental health compared to other parents. Ten percent of parents total reported that both their and their children’s mental and behavioral health had gotten worse; of these parents, 48% reported that they lost regular child care during the pandemic and 11% reported less food security than before the pandemic started.
This study isn’t perfect. For example, it simply asked people to guess whether or not their mental health got worse after the pandemic, rather than asking about specific symptoms (depression, anxiety, etc.) or actually assessing mental health before the pandemic and comparing that with mental health assessed after the pandemic started. However, it gives a snapshot into how parents felt about their and their children’s health in the early months of the pandemic - which is to say, not great!
Difficulties with distance learning affected parental mental health
Davis and colleagues (2020)4 examined data collected from the National Panel Study of Coronavirus pandemic (NPSC-19), a nationally representative survey conducted in March-April 2020 of 3,338 households in the U.S., to see how distance learning (i.e., online/remote schooling) affected parents’ mental health. This survey included a few questions to assess anxiety and depression symptoms. Additionally, the survey asked parents the question, “Have any of the children in your household struggled with their schoolwork via distance learning?” Fifty-one percent of parents reported that, yes, at least one of their children had difficulties with distance learning. These parents were also more likely to report more severe symptoms of anxiety and depression compared to other parents, even when accounting for other factors (including number of children and household income).
I liked that this study actually assessed symptoms of anxiety and depression in parents using questions from well-validated assessments (as opposed to the previously discussed study). It would have been helpful to have a more objective assessment of whether children actually struggled in distance learning (e.g., asking the children themselves) and the extent of that struggle (e.g., children with certain learning disabilities most likely struggled substantially more than children without these concerns). Based on the data, all we know is that parents’ perception of their children struggling with distance learning was associated with mental health in some fashion - it could be equally true that parents with more severe depression and anxiety symptoms were more likely to perceive that their children were struggling more with distance learning.
Chinese discrimination affected Chinese American parental and child mental health
Cheah and colleagues (2020)5 asked 543 Chinese American parents (78% mothers) along with 230 of their children (ages 10-18 years) about their experiences of racial discrimination from March through May 2020. They asked about a bunch of different types of discrimination, including in-person versus online discrimination experiences as well as whether participants believed that the media was perpetuating anti-Chinese sentiments, though I’m only going to focus on the results related to experiences of discrimination that participants reported occurring in-person. Approximately half of parents and children reported experiencing at least one instance of racial discrimination directed towards them (e.g., others being unfriendly towards them because of their ethnic background), while almost all participants (89% of parents, 92% of children) experienced at least one instance of more generalized discrimination towards Chinese people (e.g., someone saying something negative about Chinese people related to the COVID-19 outbreak).
The researchers found that these experiences of discrimination were related to a higher likelihood of both parents and children having higher scores on measures of depression and anxiety symptoms. In fact, parents’ experiences of discrimination directed specifically towards them was related a higher likelihood of anxiety and depression symptoms in their children.
I appreciate that these researchers were able to get information from both parents and children for this study (unlike the previously discussed study), and they used well-validated measures of mental health symptoms. However, it should be noted that participants in this study overall did not report severe mental health symptoms. For example, only 19 out of 230 children reported anxiety symptoms that would be considered “moderate risk” of having an anxiety disorder, and the average depression symptom rating for parents was extremely low. However, decades of research outside of the pandemic show a relationship between experiencing discrimination and mental health outcomes in marginalized groups, so these findings are not surprising, even if they are in a fairly “healthy” sample.
Struggles with distance learning, food insecurity, loss of regular childcare, and racial discrimination are indirect consequences of the pandemic that appeared to detrimentally impact the mental health of parents during the early months of 2020. The studies I summarized mostly focused on parents without (or possibly unassessed) pre-existing mental health conditions and asked questions about only general mental health symptoms (focusing mostly on depression and anxiety). Further, the academic peer-review process, from submitting a paper to a journal to getting it reviewed by other scientists to editing to publication, is long, so studies on this topic that have assessed more long-term consequences of the pandemic are on their way. These are only the tip of the iceberg. The reverberations of 2020 will be felt for awhile, and as the pandemic continues, we will continue to have more research on both the direct and indirect consequences the pandemic has on our mental health.
I linked to a NY Times article because, so far, the academic literature is focused only on case studies, i.e. descriptive reports of just one or a small number of patients who are experiencing this pretty rare condition.
Patrick, S. W., Henkhaus, L. E., Zickafoose, J. S., Lovell, K., Halvorson, A., Loch, S., ... & Davis, M. M. (2020). Well-being of parents and children during the COVID-19 pandemic: A national survey. Pediatrics, 146(4). https://doi.org/10.1542/peds.2020-016824
My hunch is that they used the phrase “behavioral health” for children since you can’t really comment on, say, a 1-year-old’s “mental health” appropriately. To me, the terms are fairly interchangeable, though it should be noted that we cannot know whether respondents viewed the terms as synonymous or not.
Davis, C. R., Grooms, J., Ortega, A., Rubalcaba, J. A. A., & Vargas, E. (2021). Distance learning and parental mental health during COVID-19. Educational Researcher, 50(1), 61-64. https://doi.org/10.3102/0013189X20978806
Cheah, C. S., Wang, C., Ren, H., Zong, X., Cho, H. S., & Xue, X. (2020). COVID-19 racism and mental health in Chinese American families. Pediatrics, 146(5). https://doi.org/10.1542/peds.2020-021816