Psychological distress in Australian parents and their children: Do parents seek help?

Psychological distress refers to emotional and psychological difficulties (such as stress, anxiety, or low mood) experienced to a degree where a person’s wellbeing and ability to function day-to-day is affected. In parents of children and adolescents, psychological distress is associated with significant negative outcomes including harmful parenting practices¹; emotional and behavioural difficulties in children²; neglect and abuse of children³; and disconnection with^4,5,6,7 interventions that address these negative outcomes.

Despite the significance of psychological distress in parents, it is an under-investigated area. It is also very rarely a main focus of child or family mental health interventions or services, despite evidence that parents with children who have emotional and behavioural difficulties typically have higher levels of psychological distress.⁸

A better understanding of the extent of psychological distress in Australian parents (and their children), their help-seeking behaviour and barriers to treatment in this area, may help inform child and family mental health service directions.

In recent years, there has been a move towards the online delivery of adult mental health services.⁹ However, the attitudes of Australian parents towards the use of online wellbeing or mental health programs is still largely unknown.

To answer some of these important questions we carried out an online survey of over 2,000 Australian parents of 4–14-year-old children.

What did our survey find?

Psychological distress

As part of the survey, parents completed a widely used measure of psychological distress (the Kessler Psychological Distress Scale: K10). Based on this measure, we found that just over 70% of parents reported moderate to very high levels of psychological distress, which can be an indication of mental health difficulties. In addition, 50% of parents indicated that at least one of their children experienced elevated levels of emotional and behavioural difficulties (on the Strengths and Difficulties Questionnaire).

Help seeking

As part of the survey, parents also indicated the types of help and support they had sought for their own or their children’s wellbeing, since becoming a parent.

Informal support options were commonly accessed. For example:

• over 50% of parents sought ‘advice from family and friends’
• over 50% had spoken to their general practitioner.

In contrast, few parents reported having accessed formal or evidence-based treatments. For example:

• fewer than 35% of parents received medication to assist with their own wellbeing
• only 26% of parents received cognitive behavioural therapy, and only 17% other forms of psychotherapy, for their own wellbeing
• only 19% of parents utilised parent-training services to assist with their child’s wellbeing.

Barriers to treatment

The majority of parents reported at least one barrier to accessing treatment for themselves (85%) or for their children (71%). These barriers were most commonly structural in nature and included:

• lack of time (parents 42%, child 19%)
• lack of money (parent 41%, child 30%).

Interestingly, parents more frequently reported structural barriers for the treatment of their own psychological distress than that of their children’s. This may suggest that parents prioritise their children’s wellbeing over their own.

In addition, childcare responsibilities and not considering problems severe enough to warrant treatment were commonly reported barriers to parents seeking help.

Interest in an online parental wellbeing course

Parents were also asked about their level of interest in a free online course designed to help parents manage and improve their own and their children’s wellbeing. They were told the course would provide the same kinds of information and teach the same kinds of skills parents would learn if getting face-to-face assistance with a psychologist.

Approximately 80% of parents felt that the online parental wellbeing course would be helpful and over 70% indicated that they would be interested in taking part in such a course.

This survey highlighted that Australian parents of 4–14-year-olds experience high rates of psychological distress and care for children with elevated emotional and behavioural difficulties. Despite this, relatively low rates of formal help-seeking and high rates of barriers to seeking treatment were reported. Encouragingly, the survey suggests that an online parental wellbeing course may offer an acceptable alternative to face-to-face treatment that may overcome many of the identified barriers.

Implications of the survey

We believe engagement with and response to child and family mental health interventions will improve by also addressing parental psychological distress. We argue that greater attention is needed to assist parents in accessing interventions to manage their mental health in the context of being a parent. These interventions could be offered in conjunction with traditional child and family mental health or parenting services. In addition, the online delivery of such interventions is likely an acceptable and accessible option for health services to consider.

Further reading

Tapp, B., Gandy, M., Fogliati, V. F., Karin, E., Fogliati, R.J., Newall, C., Titov, N., & Dear, B. F. (2018). Psychological distress, help-seeking, and perceived barriers to psychological treatment among Australian Parents. Australian Journal of Psychology, 70, 113–121.

Authors

Milena Gandy, the eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.

Lauren F. McLellan, Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.

Brit Tapp, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia.

Acknowledgments

The authors gratefully acknowledge all the participants for their involvement in the survey. The authors thank the eCentreClinic and the Department of Educational Studies, Macquarie University, for their promotion of the research. Milena Gandy is supported by a Macquarie University Fellowship.

References

¹ Nelson, S. K., Kushlev, K., & Lyubomirsky, S. (2014). The pains and pleasures of parenting: When, why, and how is parenthood associated with more or less wellbeing? Psychological Bulletin, 140(3), 846–895. DOI: https://doi.org/10.1037/a0035444
² Parry-Langdon, N. (2008). Three years on: Survey of the development and emotional wellbeing of children and young people. London: Office for National Statistics 2008
³ Milner, J. (2003). Social information processing in high-risk and physically abusive parents. Child Abuse and Neglect, 27, 7–20. DOI: https://doi.org/10.1016/S0145-2134(02)00506-9
⁴ Nock, M. K., & Ferriter, C. (2005). Parent management of attendance and adherence in child and adolescent therapy: A conceptual and empirical review. Clinical Child and Family Psychology Review, 8(2), 149–166. DOI: https://doi.org/10.1007/s10567-005-4753-0
⁵ Cobham, V. E., Dadds, M. R., & Spence, S. H. (1998). The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting and Clinical Psychology, 66(6), 893–905. DOI: https://doi.org/10.1037/0022-006X.66.6.893
⁶ Kendall, P. C., Hudson, J. L., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioural therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76(2), 282–297. DOI: https://doi.org/10.1037/0022-006X.76.2.282
⁷ Kjøbli, J., Naerde, A., Bjørnebekk, G., & Askeland, E. (2013). Maternal mental distress influences child outcomes in brief parent training. Child and Adolescent Mental Health, 19(3), 171–177. DOI: https://doi.org/10.1111/camh.12028
⁸ Hudson, J. L., Newall, C., Rapee, R. M., Lyneham, H. J., Schniering, C. C., Wuthrich, V. M., … Gar, N. S. (2014). The impact of brief parental anxiety management on child anxiety treatment outcomes: A controlled trial. Journal of Clinical Child and Adolescent Psychology, 43(3), 370–380. DOI: https://doi.org/10.1080/15374416.2013.807734
⁹  Titov, N., Dear, B. F., Staples, L. G., Bennett-Levy, J., Klein, B., Rapee, R. M., . . . Nielssen, O. B. (2015). MindSpot Clinic: An Accessible, Efficient, and Effective Online Treatment Service for Anxiety and Depression. Psychiatric Services, 0(0), appi.ps.201400477. doi:doi:10.1176/appi.ps.201400477.