A major new study published in JAMA Internal Medicine has revealed a sharp and troubling decline in mental health among mothers in the United States over the past decade, a trend that experts say has wide-ranging implications for families, communities, and even international health policy—including in Thailand. The percentage of US mothers self-reporting “excellent” mental health plummeted from 38.4% in 2016 to just 25.8% in 2023, while the proportion rating their mental health as “fair” or “poor” soared by more than 60% during the same period. These findings, based on a nationally representative survey of nearly 200,000 mothers, shine an urgent spotlight on the challenges facing parents and the cascading consequences for child and societal well-being.
This news resonates keenly for Thai society, where maternal well-being is deeply interwoven into family, community, and national strength. For decades, the United States has been looked to as a model for modern maternal and child health systems. This new data, however, signals that even high-income countries are struggling to support mothers’ mental health. As Thailand negotiates the ongoing reforms to its own mental health, social welfare, and family policy structures, the American experience is a timely and cautionary tale.
According to the JAMA Internal Medicine report, which analyzed data from the US National Survey of Children’s Health from 2016 to 2023, the percentage of mothers who rated their mental health as “excellent” dropped precipitously, accompanied by a significant rise in “good” and especially “fair/poor” responses. Importantly, these declines did not begin with COVID-19: “Downward trends in excellent maternal mental and physical health originated before the COVID-19 pandemic,” the authors noted, pointing instead to broader societal shifts (“jamanetwork.com”; see also ABC News coverage).
Lead author Jamie Daw, PhD, of the Columbia University Mailman School of Public Health, highlighted the breadth and impact of the findings: “We found a dramatic increase in mothers reporting fair or poor health—a 64% increase.” Concerningly, declines were observed across all demographic and socioeconomic groups, but mothers who were single, younger, less educated, or had children who were publicly insured or uninsured faced particularly steep challenges.
Physical health also worsened, with the share of mothers reporting “excellent” physical health dipping from 28% to just under 24%. Yet it was the statistical jump in mental distress that most alarmed clinicians and policymakers. Dr. Jade Cobern, a pediatrician and preventive medicine specialist, stressed, “Poor mental health contributes to maternal mortality, and it increases the risk of health problems for both mom and baby. As a pediatrician, I know firsthand that a mother’s health is integral to a child’s overall well-being. Taking care of mothers must be seen as taking care of the whole family.”
The impact of maternal mental health extends far beyond the individual. Numerous studies have documented the ripple effects, from greater risks during childbirth and infancy to adverse long-term outcomes in children’s physical and emotional development (jamanetwork.com). Indeed, the study’s results align with rising US rates of depression, anxiety, and even mental health-related mortality, including suicide and drug overdose, in women of reproductive age. Maternal mental health conditions are now the leading cause of pregnancy-related death in the US, accounting for nearly a quarter of such deaths in recent years.
Perhaps most sobering for policymakers is that these challenges are not confined to a single group. The study observed, “Mental health declines occurred broadly across socioeconomic subgroups,” yet mothers who were single, younger, less educated, or had multiracial, publicly insured, or uninsured children reported significantly higher odds of fair or poor mental health. This points to both the universality of the issue and the need for targeted interventions to address the structural drivers of inequity.
A striking point raised by the research is the minimal impact attributed to the COVID-19 pandemic per se; the declines pre-date the crisis. While the pandemic intensified existing stressors, such as social isolation and economic uncertainty, the roots of this decline appear entangled with broader factors—limited access to affordable mental health care, rising cost of living, income inequality, racism, gun violence, changing family structures, and the deepening challenges of work-life balance.
The study also examined paternal mental health trends, finding similar—albeit less severe—declines among fathers. Notably, the prevalence of “fair/poor” mental health in 2023 stood at 8.5% for mothers and 4.5% for fathers, a disparity that, while narrowing, remains significant. This signals the need for comprehensive parental, not just maternal, mental health supports and highlights evolving patterns in family stress and wellbeing.
For Thailand, these findings underscore several key issues. Thai maternal mental health, especially outside of the perinatal period, is historically under-researched and often shrouded in stigma. Recent local studies have begun to illuminate rising rates of postpartum depression, anxiety among mothers of preterm infants, and mental health impacts from COVID-19-related stress (PubMed Thailand study). Thai society, with its deep intergenerational family ties, has unique strengths but also distinctive challenges—including high rates of family separation (e.g., due to labor migration), changing social expectations for motherhood, and disparities in access to mental health resources between urban and rural settings.
Cultural expectations play a significant role. In Thailand, mothers are often seen as the “pillar of the family,” expected to be self-sacrificing and emotionally resilient. This can make it difficult for women to acknowledge mental distress or seek help. Meanwhile, government and community-level mental health initiatives are only recently starting to shift toward a wider recognition of depression, anxiety, and parental burnout as part of routine healthcare screening.
The lessons from the US research are clear: societies worldwide must invest proactively in maternal (and parental) mental health prevention, diagnosis, and treatment—not simply during pregnancy and childbirth but throughout the many years of parenting. The US Surgeon General’s 2024 advisory, “Parents Under Pressure,” urged a re-conceptualization of parental mental health as a critical public health priority, calling for policy action, expanded community mental health resources, workplace reform, social insurance enhancements, and broad cultural shifts to reduce stigma (jamanetwork.com). The US experience reminds Thai policymakers and health leaders that mental health challenges are not isolated or sudden events, but the cumulative result of structural factors—inequity, care access, family instability, and generational shifts.
Looking forward, Thailand has an opportunity to learn from these global trends and anticipate the urgent need for more robust support systems. These might include the expansion of community-based mental health services, routine maternal mental health screening in primary care clinics, subsidized counseling programs, parental leave reforms, and national media campaigns to destigmatize mental health help-seeking. Schools and youth organizations can also play a vital role by providing education and referral services for struggling parents and children alike.
For individuals, especially mothers and fathers who may be feeling overwhelmed, the US experience sends an important message: seeking help is not a failure but an act of strength. The voices of Thai medical professionals—including those in pediatrics, family medicine, and mental health—have increasingly affirmed that “taking care of your own mind is a cornerstone of taking care of your family.” Social support, whether through formal counseling or informal networks, can make a world of difference.
Finally, the ongoing reforms to Thailand’s healthcare and social welfare systems represent a critical inflection point. Integrating modern mental health services into universal health coverage, enhancing work-family protections, and fostering community understanding are investments that will pay dividends for generations. As research reveals, the well-being of mothers is not just a women’s issue but a profound barometer of national resilience and future prosperity.
Through the lens of the US maternal mental health decline, Thai society can see the risks of waiting for crisis before acting—and the benefits of proactive reform. The future health of Thai families and children may depend on heeding these warnings and building a mental health safety net robust enough for all.
Conclusion and Recommendations for Thai Readers:
- Recognize early signs of mental distress in mothers and caregivers, and encourage open conversations within families and communities.
- Advocate for expanded mental health services, including routine maternal screening at community health centers.
- Support policy initiatives that promote family wellbeing, work-life balance, and access to affordable mental healthcare.
- Promote workplace cultures and family laws that value parental well-being, including adequate leave and flexibility.
- Reduce stigma through public education campaigns about mental health and seeking support.
- Encourage intergenerational support structures, drawing on traditional Thai values while modernizing approaches to mental health.
The health of mothers is the health of the nation. By learning from global trends and taking practical local steps, Thai families and communities can foster resilience and shared well-being in challenging times.
Sources:
- JAMA Internal Medicine: Trends and Disparities in Maternal Self-Reported Mental and Physical Health (May 2025)
- ABC News: Only 25% of moms in US report ‘excellent’ mental health (May 2025)
- PubMed: Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand (2025)