A study conducted Mental Health Foundation based in the United Kingdom (UK) found that approximately 68% of women and 57% of men with mental health problems are parents.
Another study conducted by Norhafizah et al. (2021) within the local context analysed data from the National Morbidity Survey (NHMS) 2015. Among 4,309 children aged 5 to 15 years who participated, approximately 42.5% of their parents were reported to experience some form of mental health problems.
The mental health struggles of these modern parents extend beyond parental burnout or psychological distress, affecting the overall well-being of the family institution.
Prevalence and trend of parental mental illness
While mental illness affects both parents, including when both parents are working, studies have indicated that the prevalence of parental mental illness is generally higher in mothers than fathers, especially among stay-at-home mothers (unpaid homemakers). This is due to the pressure and responsibilities of excelling in multiple roles—caregiver, educator, homemaker —while also maintaining a harmonious family dynamic.
According to a 2018 research published by the International Labour Organisation (ILO), in Asia and the Pacific alone, unpaid care labour amounts to 8.9 billion hours. The data shows that women carry out over three times as much unpaid care labour as men, accounting for 76.2% of all hours worked in this capacity worldwide. In Asia and the Pacific, this statistic rises to 80%, with women spending 4.1 times more time in unpaid care work than men.
While there has been progress in increasing the Labour Force Participation Rate (LFPR) among women in the country, a significant disparity persists compared to their male counterparts.
The Q4 2023 Labour Force Survey Report (LFPR) showed an increase, with a significant portion of the outside labour force being female, accounting for 70.6% or 5.08 million persons. In contrast, males comprised 29.4% or 2.12 million persons. The primary reason for individuals being part of the outside labour force was attributed to housework/family responsibilities (42.6%), followed by schooling/training (41.2%).
In addition, maternal mental illness is more prevalent among mothers during the postpartum period (refer to “Rising Concern on Perinatal Mental Healthcare in Malaysia”, 2023). This is related to hormonal fluctuations, sleep loss, physical recuperation, emotional adjustment, and a lack of social support that mothers often experience during this time.
Apart from negatively affecting the parent-child bond, these mothers are more likely to develop long-term mental health issues that can impair everyday functioning, increase emotional distress, and elevate the risk of self-harm or even suicide ideation without appropriate care and intervention.
Often overlooked, parenting can be especially challenging, stressful, and overwhelming for parents of children with chronic illnesses and disabilities. The mental health of these parents is a pressing concern, as they navigate the complex emotions, practical challenges, and social stigma associated with caring for a child with special needs.
A study conducted by Rosilah et al. (2022) using the Kessler Psychological Distress Scale (K10) among 224 parents of children with disabilities in Terengganu found that 36.6% of parents were having severe distress, 21% were experiencing moderate distress, and 21.9% had mild distress.
Given that the Malaysian government is still far behind in providing quality access to education and healthcare for people with disabilities (refer to "Enhancing the special education system for special needs children", 2023), parents are forced to fork out for private therapy and education interventions. Generally, the monthly cost of occupational and physical therapy packages for children with disabilities in the market may vary from RM 4,000 to RM 10,000 or more, depending on the packages offered by private centres.
This can be especially difficult for parents who cannot afford these expenses and may resort to taking out loans, etc., to support their children. Such persistent financial difficulties in daily lives can severely impact parent-child relationships and contribute to mental health issues for both, parents and children.
Contributing factors affecting the mental health of parents
As emphasised enough, the rising cost of living, coupled with stagnant wages and economic uncertainty in Malaysia, has significantly pressured parents in providing for the family.
Financial strain on parents can lead to feelings of anxiety, hopelessness, and inadequacy as they struggle to meet their family’s basic needs and provide for their children. The 2022/ 2023 Belanjawanku expenditure guide estimates that the minimum monthly budget for a family of four in the Klang Valley is RM 6,890. It is important to note that this expenditure does not account for additional expenses related to extracurricular activities, hobbies, and other necessities that parents must provide for the well-being of their children.
Furthermore, despite the increasing number of policies for childcare centres being implemented, the instances of child abuse cases, coupled with the limited availability and affordability of childcare centres, have compelled many mothers to quit the job market to care for their children.
This situation impacts the mental health and well-being of fathers, especially when they are forced to take on multiple jobs to provide for the family as the sole breadwinner. Additionally, instances of sudden layoffs by companies have detrimental effects on the mental health of parents. Research by Diana et al. (2016) involving 59 unemployed parents found that half of the participants (52.5%) experienced high psychological stress due to unemployment.
On top of that, poor work-life balance significantly impacts interpersonal relationships within marriage. Prolonged working hours, increased work-related stress, and excessively heavy workloads disrupt marriages through poor communication, breakdowns, neglect of familial responsibilities, and decreased quality time with family.
This leads to a high risk of marital conflicts and dissatisfaction, which significantly affects parental mental health. Behind closed doors, where these struggles often unfold, there are heightened risks of stress, anxiety, loneliness, depression, and, in the worst cases, substance abuse, domestic abuse and divorce.
The impact of parental mental health struggles on children is profound and multifaceted, potentially leading to intergenerational patterns of mental illness. These struggles can also negatively influence children’s socio-emotional development, academic performance, and overall well-being.
For instance, Anna et al. (2022) suggest that up to 60% of children exposed to maternal depression during the first five years of life may develop psychological disorders at some point in their lives. Another study conducted by Mercy (2018) in Nairobi found that among 347 respondents (including principals, teachers and students), 96.7% noted that parental quarrels negatively affected the academic performance of children.
Recently, the occurrence of the “forgotten baby syndrome (FBS)” has been on the rise and a buzz topic in the media. While distractions (phone calls etc.) and routine disruptions are attributed to this phenomenon, it is often overlooked and underestimated that parents are overwhelmed and experience heightened levels of stress and fatigue due to burnout from work and familial responsibilities, which may also significantly contribute to such incidents.
There is no one-size-fits-all approach to eliminate the mental struggles of parents; however, one way to alleviate this situation is by providing support and assistance to parents who need mental health services.
Recently, the Human resource minister, YB Steven Sim, announced that employees can now apply for flexible working arrangements. However, this initiative should not stand alone.
While this will increase labour force participation and provide more flexible working arrangements for employees, employers may exploit the policy by imposing additional hours and workload.
Therefore, implementing specific key performance indicators (KPIs) and a framework to monitor and regulate the flexible working arrangement policy must safeguard the well-being and rights of employees and employers too, as flexible working arrangements should not equate to subservient quality of work. Such a framework can be potentially shared with the progressive wage policy.
Employers frequently fail to address the mental health of their staff, which results in ignorance and a lack of concern in the workplace. To solve this issue, companies should explore long-term investments in mental health programs, for instance, providing mental health coverage, such as from the AIA insurance agency (AIA Mental Health Solution). Companies that prioritise employee well-being can improve retention rates, boost performance, and ultimately increase revenue.
Initiatives like town hall meetings or anonymous feedback systems can assist in discovering problems in the workplace, including work-related and management issues, allowing employees to express their concerns without fear of retaliation. Developing a culture of open communication and openness is critical for creating a healthy work environment.
Finally, as previously emphasised in EMIR Research’s articles, the Ministry of Health (MOH) must urgently address the scarcity of qualified professionals in the field of mental health, such as counsellors, psychologists, and psychiatrists. Increasing the availability of mental health professionals can ensure that individuals have access to the support they need to cope with mental health challenges.
In conclusion, parents are often "sandwiched" due to their multiple responsibilities, leading to increased stress and fatigue, more common among caregivers who are responsible for both children and ageing parents, hence the term "sandwich generation”.
It is important to adopt an overall comprehensive approach involving government intervention and assistance, company initiatives, and community participation in promoting better mental health care.
Jachintha Joyce is a Research Assistant at EMIR Research, an independent think tank focused on strategic policy recommendations based on rigorous research.
** The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the position of Astro AWANI.
