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Global Warning: US mothers’ declining mental health offers lessons for Thailand’s family policies

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A major study published in JAMA Internal Medicine shows a sharp decline in mental health among US mothers over the past decade. The findings highlight how societal pressures, economic stress, and gaps in care affect families and could inform policy in Thailand as it strengthens its own maternal support systems. In the United States, self-reported “excellent” mental health among mothers fell from 38.4% in 2016 to 25.8% in 2023. The share rating their mental health as “fair” or “poor” rose by more than 60% in the same period, based on a nationally representative survey of nearly 200,000 mothers. The results emphasize the broad impact on child development, family stability, and community health.

Thai society closely watches maternal well-being because it affects families, communities, and economic resilience. While the United States has long been a reference for health systems, this data shows that even high-income nations face mounting pressures on mothers’ mental health. Thailand is currently reforming mental health services, social welfare, and family policies, and the American experience offers timely insights for local decision-makers.

The JAMA Internal Medicine study analyzed data from the US National Survey of Children’s Health from 2016 to 2023. It notes a steep decline in mothers rating their mental health as excellent, with a notable rise in those who report only good, fair, or poor health. Crucially, the declines began before the COVID-19 pandemic, suggesting deeper structural forces at work—rather than a temporary crisis. The authors point to factors such as limited access to affordable mental health care, rising living costs, income inequality, racism, and evolving family structures, all contributing to weaker mental health among mothers.

Dr. Jamie Daw of the Columbia University Mailman School of Public Health stresses the breadth of the issue: a 64% increase in mothers reporting fair or poor health. Declines span all groups, but single, younger, less educated mothers or those with publicly insured or uninsured children face higher risks. Physical health also worsened in tandem, but the shift in mental health drew the most concern for clinicians and policymakers, given its links to mortality and child well-being.

The ripple effects are well documented. Poor maternal mental health is associated with higher risks during childbirth and infancy and can influence long-term physical and emotional development in children. While the study also found declines among fathers, the gap remains substantial, underscoring the need for family-wide mental health supports.

For Thailand, these findings underscore several local priorities. Maternal mental health outside the perinatal period has been under-researched and sometimes stigmatized. Recent Thai studies highlight rising postpartum depression and anxiety among mothers of preterm infants, with COVID-19–related stress contributing to mental health burdens. Thailand’s family structures—often characterized by strong intergenerational ties—face challenges such as labor migration, urban-rural disparities in access to care, and evolving expectations of motherhood. These dynamics call for culturally sensitive, accessible mental health services integrated into primary care.

Cultural expectations in Thailand can compound stigma around mental distress. Mothers are frequently seen as the backbone of the family, which may discourage seeking help. Fortunately, health authorities and communities are increasingly recognizing depression, anxiety, and parental burnout as legitimate health concerns warranting routine screening and broader support.

The US experience reinforces a clear message for Thai policy: invest early in maternal and parental mental health, beyond pregnancy and childbirth. Authorities have urged a comprehensive approach that expands community resources, reforms workplaces, strengthens social insurance, and reduces stigma. For Thailand, this translates into practical steps: expand community-based mental health services, introduce routine maternal mental health screening in primary care, subsidize counseling, and reform family-friendly leave policies. Schools and youth organizations can help by providing education and referral pathways for struggling families.

For individuals, seeking help is a sign of strength, not weakness. Thai clinicians—pediatricians, family physicians, and mental health specialists—emphasize that supporting a mother’s mental health supports the entire family. Building social support networks, whether through counseling or community groups, can make a meaningful difference.

Thailand’s ongoing health and social reforms present an opportunity to safeguard maternal well-being. Integrating mental health care into universal health coverage, expanding work-family protections, and promoting public education about mental health can yield long-term dividends for families and the nation. The well-being of mothers is a bellwether for national resilience and future prosperity.

Actionable takeaways for Thai readers:

  • Recognize early signs of mental distress in mothers and encourage open dialogue within families and communities.
  • Support routine maternal mental health screening in community clinics.
  • Promote policies that improve work-life balance and access to affordable mental health care.
  • Encourage workplace practices and leave policies that value parental well-being.
  • Fight stigma through public education and accessible support options.
  • Leverage intergenerational support rooted in Thai values while expanding formal mental health resources.

The health of mothers reflects the health of the nation. By learning from global trends and translating them into local action, Thai families can strengthen resilience and well-being now and in the years ahead.

In summary, the US evidence is a warning and a guide: timely investment in maternal and parental mental health is essential to prevent crises and build a healthier society.

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Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making decisions about your health.