Being on parental leave is protective against poorer mental health particularly among mothers, with evidence of this beneficial effect continuing in later life, according to a systematic review in The Lancet Public Health.

Researchers from the Department of Public Health Sciences at Stockholm University and the Department of Global Public Health at Karolinska Institutet have conducted a systematic review investigating the relationship between parental leave and mental health in parents from an international perspective.

"Becoming a parent can be stressful for both parents. We tend to just think about the enormous hormonal and physical changes experienced by the mother, but we must also think the transition to parenthood is stressful for couples," says Sol P Juárez, Associate Professor and Senior Lecturer at the Department of Public Health Sciences, Stockholm University, and Principal Investigator of the study.

For example, parents face challenges related to child care, career uncertainties and financial pressures due to reduced income.

"This is perhaps why mental disorders after childbirth are relatively common; it is usually said that 10 to 20 percent of the mothers and up to 10 percent of the fathers are affected. Therefore, we wanted to systematically examine all the published scientific evidence to see whether parental leave may help alleviate mental health symptoms among parents," says Juárez.

The review concludes that parental leave was protective against poorer mental health, including depressive symptoms, general mental health, psychological distress, burnout and mental healthcare use, particularly for mothers.

"However, the beneficial effects are associated with more generous parental leave schemes, for example with longer duration of leave," highlights Amy Heshmati, doctoral candidate and the first author of the study.

The researchers searched five online databases until August 29, 2022. A total of 45 studies were included in the study.

"This is the most comprehensive systematic review on this topic to date. We have looked for a connection between different aspects of parental leave, such as length of leave and whether leave was paid or unpaid, and their associations with mental health in both mothers and fathers. We even investigated the indirect effect of one parent taking parental leave on their partner's mental health," says Amy Heshmati.

"An interesting finding is that the beneficial effects are not only observed shortly after childbirth, but that these protective effects of parental leave can continue into later life for mothers," say Helena Honkaniemi, postdoctoral researcher and author of the review.

Findings among fathers were inconclusive. "Less research has been done on fathers and still this research suggests that fathers have improved mental health with parental leave policies that offer adequate wage replacement or incentives, such as uptake quotas," adds researcher Helena Honkaniemi.

The review demonstrates that generous parental leave may help to alleviate or prevent mental health symptoms, especially for mothers, a finding that is highly relevant from a policy perspective.