Measuring mental and emotional health in parents of young children

Rebecca Webb talks about reliable and valid measures that practitioners can use to assess parents’ wellbeing during a child’s early years

Mother smiling at baby Postnatal mental health problems are thought to affect around 10-20% of women (Mann, Gilbody and Adamson, 2010) and around 8% of men (Cameron, Sedoc and Tomfohr-Madsenl, 2016 ; Parfitt and Ayers, 2014).

Research suggests that if a parent suffers from postnatal mental health problems such as anxiety, depression and post-traumatic stress disorder (PTSD), this can have long lasting consequences for their child’s development (Garthus-Niegel et al, 2017 ; Goodman et al, 2011 ; O’Donnell et al , 2014). By identifying parents with mental health problems in the early years (when their child is aged 0-5), we could reduce the negative impact.

Within the NHS women are screened for depression and anxiety for up to a year after they give birth, but this leaves out fathers and women who suffer from mental health problems for longer than a year after their baby is born.

I worked on a systematic review of the literature, aiming to identify which measures could be used to assess parental wellbeing in both mothers and fathers up to 5 years after their child’s birth. In this blog I’ll be summarising the findings.


The review looked at academic papers which included global measures of mental or emotional wellbeing in expectant parents or parents to children in the early years. It aimed to identify whether the measures were reliable (providing the same results over time) and valid (measuring what they are intended to measure).

The literature search identified 183 studies that used a measure of global parental mental health, which were carried out in 46 different countries. Only a small number of these included fathers (7 with fathers only; 29 with mothers and fathers) and only 24 studies looked at parental mental health for parents of children aged 0-5.

The review identified 24 different measures of global parental mental health. 4 of these had been specifically examined for their reliability and validity. These were:

The GHQ was the most extensively examined measure, but the results suggest it has poor validity in the early years parenting population. Results also suggest that the GHQ has poor reliability when used to test and re-test parents during the early years.

The SRQ had good validity when used with mothers. It’s fairly short (20 items), free to use and available in 5 languages. However, it has not been validated with fathers.

The K10/6 had validity when used with mothers and it has also been used with fathers. Again it’s brief (6 items), free to use and available in 4 languages.

However, we do need to take some things into account when drawing conclusions from the findings of the study:

  1. We found relatively few studies that directly validated measures of parental mental health during a child’s early years. This makes it difficult to draw conclusions or make firm recommendations about the ideal measure to screen for emotional wellbeing in this population.
  2. Some of the measures were developed many years ago. Older measures are more likely to have been validated in different populations, so they may be over-represented in literature reviews. There may be other new measures that are promising but have not yet been evaluated. So more research needs to be done to validate newer measures in this population.

Moving forwards 

Illustration mother and daughterThis review identified 2 promising global measures of parental mental health during the first 5 years of a child’s life, in terms of psychometric properties and clinical utility:

  • Kessler Psychological Distress Scale (K10/6); and
  • Self Report Questionnaire (SRQ).

However, as I’ve discussed more research is needed to identify all the valid and reliable measures of parental mental health during the first 5 years of a child’s life. This will enable practitioners to screen for problems more effectively and potentially prevent the long term negative impact this can have on children’s development.

More information 

 More information about the findings of the review

A systematic review of measures of mental health and emotional wellbeing in parents of children aged 0–5

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  1. Cameron, E.E., Sedov, I.D., Tomfohr-Madsen, L.M. (2016) Prevalence of paternal depression in pregnancy and the postpartum: an updated meta-analysis. Journal of affective disorders 206: 189–203.

  2. Derogatis, L.R. et al (1974) The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behavioural Science 19 (1), 1–15.

  3. Goldberg, D., Williams, P. (1988) A User's Guide to the General Health Questionnaire. Windsor: NFER-Nelson.

  4. Goodman, S. H. et al (2011). Maternal depression and child psychopathology: a meta-analytic review. Clinical child and family psychology review, 14 (1): 1-27.

  5. Kessler, R.C. et al (2003) Screening for serious mental illness in the general population. Arch. Gen. Psychiatry 60 (2), 184–189.

  6. Mann, R., Gilbody, S., Adamson, J. (2010) Prevalence and incidence of postnatal depression: what can systematic reviews tell us? Archives of Women's Mental Health 13 (4): 295–305.

  7. Parfitt, Y., Ayers, S. (2014) Transition to parenthood and mental health in first-time parents. Infant Mental Health Journal 35 (3): 263–273. 

  8. World Health Organisation (1994) Self-Reporting Questionnaire. Geneva: World Health Organisation.