THE CONVERSATION — It’s no secret that the COVID-19 pandemic has taken a heavy toll on the mental health of kids and parents alike.

In a 2020 survey, 71% of parents said they believed the pandemic had hurt their children’s mental health. The American Academy of Pediatrics declared a national emergency in child mental health in October 2021, citing “soaring” rates of child mental health challenges.

In 2022, the Biden administration developed a comprehensive strategy and committed a substantial amount of money, including US$300 million secured through a bipartisan agreement, to a national response to the children’s mental health crisis through multiple sources.

But what is often missing from this national conversation is the importance of recognizing parents’ mental health and the effect that parents’ mental well-being has on that of their children. Decades of research clearly demonstrate that the mental health of parents and their children are inextricably linked.

As an assistant professor of child and family development whose research focuses on parenting and child mental health, I see too often that the mental health of parents – or other caregivers who act in the role of parents, such as grandparents or foster parents – is overlooked when trying to support children’s mental health. Until that gap is addressed, efforts to address the mental health crisis in kids and teens will likely fall short.

The pandemic’s toll on parents

The work of multiple researchers, including my own group, shows that parents reported alarmingly high rates of mental health challenges during the COVID-19 pandemic.

In my own work on the subject, a 2021 study found that 34% of parents reported elevated anxiety symptoms, and approximately 28% of them reported depression symptoms that were at a point of clinical concern.

These rates were similar to other reports, and they suggest that parents had higher levels of mental health needs than before the pandemic. The preponderance of research into the pandemic’s toll on parents’ and children’s mental health took place in 2020 and 2021, so it’s not yet clear whether mental health needs have lessened as the pandemic has waned or not.

Passing on the pain

Parents’ psychological health is important in its own right, since they often experience stress and need support. But research is also clear that the well-being of parents is closely linked to that of their child. Parents who are experiencing mental health challenges often have children with mental health challenges, and vice versa.

This interplay is complex and varied and includes both genetics and environmental factors such as exposure to stress or trauma. Parents’ well-being directly affects the overall structure and functioning of the home environment, such as following daily routines, and the quality of the relationship between parent and child.

For example, when parents experience depression, they often express more negative emotions – such as anger and irritability – with their children. They are also less consistent in discipline and less engaged in the parent-child relationship. As a result of these stresses at home, their children may also develop depression as well as other challenges, such as anxiety or behavioral problems.

Children of parents with high levels of anxiety are at risk for both anxiety and depression, which themselves are associated with attention-deficit/hyperactivity disorder. And ADHD is known to be highly hereditary: One study found that approximately 50% of children with ADHD also had a parent with ADHD.

Parents’ mental well-being is influenced by the amount of stress they experience, such as economic difficulties, insufficient child care and competing pressures from work and family. When parents have social support from family, friends, their community or the school system, studies show they are less likely to struggle with anxiety or depression.

Treatment for parents also helps kids

In a recent review on parental depression, researchers reported that children who are receiving mental health care often have parents with depression, and many times the parents’ depression is not being treated. Importantly, the review also found that when parents are treated for depression and see their depressive symptoms improve, their children’s psychiatric symptoms abate and overall functioning improves. It also concluded that the treatment of parent and child mental health challenges is rarely integrated.

There are, however, emerging approaches for bringing the two together, including screening for and treating both parent and child mental health challenges in pediatric primary care. While this approach to identifying and treating psychiatric conditions is new, studies show it is promising for reducing depression symptoms in both parents and children simultaneously.

When parents are not able to receive effective treatment for their psychiatric conditions because of their busy schedules, inability to afford it, stigma against mental health care or the mental health provider shortage, children are put at risk for mental health challenges too. On the flip side, when parents receive evidence-based mental health care, such as cognitive behavioral therapy, children also benefit.

Research also shows that a family-based approach to mental health care that considers parents’ needs, the family context and the parent-child relationship may best support both children and their parents.

Prioritizing parents

So often, parents feel they need to take a back seat to what they perceive as the more important needs of their children. But just as when airline flight attendants instruct adults at the start of every flight to put their own safety mask on first, parents should know the importance of prioritizing their own well-being to promote the health of their children.

One concrete action that parents can take is to seek out family-based treatments. This may be a challenging process, but talking with their child’s pediatrician about specific referrals for this kind of care can be a good place to start. If those options are not available, parents should ensure that they are involved in their child’s mental health care and incorporate what is learned in treatment into their family’s day-to-day life. They should also seek referrals for their own mental health care as needed.

Ultimately, the children’s mental health crisis cannot be solved without also prioritizing parents. The British psychiatrist John Bowlby is widely recognized as the father of attachment theory, the study of the importance of early relationships between infants and their caregivers. Bowlby often expressed the sentiment that “a society that values its children should cherish their parents.”