Caregivers need care, too.
This month I want to highlight the U.S. Surgeon General, Dr. Vivek Murthy’s recent advisory on the parent mental health crisis, entitled: Parents Under Pressure: The U.S. Surgeon General Advisory on the Mental Health and Well-Being of Parents. According to this report, in 2023, one-third of parents reported experiencing extreme stress over the past month, compared to only 20% of other adults; 48% reported that they are completely overwhelmed on most days, compared to 26% of other adults.
Awareness about youth mental health has grown considerably in recent years, and it is exciting to see this long-overdue focus on parent well-being, as well! After all, we can only get so far helping our youth without engaging and enlisting the help of parents! Given the heritability of many psychological disorders and the stress of parenting, parents may have unmet mental health needs that pose challenges with parenting and scaffolding their children’s progress in therapy.
Many parents put aside their own needs for the good of their children. This has increased in recent years and contemporary terms like “overparenting” refer to the fact that many of today’s parents are going above and beyond in terms of enrichment activities and packed schedules to a degree that most of us do not remember from our own childhood. Indeed, 70% of parents reported feeling like parenting is far more stressful than it was 20 years ago. It is very likely that social media (or the “culture of comparison,” as Dr. Murthy astutely put it) is leading many parents to have high, often unrealistic, expectations for themselves and their children, which can lead to feelings of guilt and inadequacy.
Stress is, of course, compounded for parents living in poverty, who are additionally concerned with housing and/or food insecurity, neighborhood safety, social isolation, and the like. A whopping one in four parents in the U.S. said that there have been times in the past year when they didn’t have enough money to cover basic needs. Dr. Murthy’s report highlighted that families living with social disadvantage are especially in need of support and policies to enhance their well being, for their sake and their children’s. We simply need to do better.
What can we, as mental health providers and clinical researchers, do to help?
First and foremost, we can take a moment to ask parents how they are doing, and to give them time and space to express their thoughts and feelings. Some might challenge us and say that parent mental health is outside our purview as clinical child and adolescent psychologists; however, parent mental health is highly relevant to our clinical work on parenting and child’s mental health. Indeed, decades of research (including from my own lab) demonstrates the profound impact of parent mental health on child mental health.
Now, not all parents will feel comfortable talking about their own mental health. But, over time, as they come to trust their provider, hopefully that will change. It is important to recognize that all parents, not just those with a diagnosis, could benefit from well-established cognitive-behavioral tools like pleasant activities scheduling, thought challenging, mindfulness, acceptance, and organizational skills. Integrating these parent-focused components into our evidence-based treatments (EBTs) for youth could be helpful. Research conducted in my lab has shown that parenting interventions for youth with ADHD that integrate a parent mental health component result in better outcomes than a standard parenting program without a focus on parent mental health.
Our research should continue to incorporate a focus on how to support parents’ mental health and wellness, including: how to screen in a manner that is acceptable to parents; how best to raise such discussions sensitively for parents from different cultures; when to incorporate parent wellness into child therapy; and when to refer out. In line with the theme of the 2024 APA Conference, qualitative approaches in which we ask parents about their lived experience with parenting and the day-to-day stressors they face can be particularly useful in helping us to understand how we can help.
Universally, we want to spread the message that parenting is not always easy, and normalize feelings of stress, perhaps by creating communities of parents who can support one another. Policymakers can work to acknowledge the challenges parents face and identify ways to support them. This is particularly necessary for parents living in poverty and isolation.
The evidence is clear that we simply cannot ignore parent mental health in our work with youth! I am thrilled to see Surgeon General Dr. Murthy using his platform to send the message that “caregivers need care, too.”
The Surgeon General’s full report can be found here.
