New thesis reveals flaws in parental insurance design and mental health support

Generous parental insurance can improve the mental health of new parents. However, the way the insurance is designed excludes those who need the support most. This is shown in a new doctoral thesis from Karolinska Institutet and Stockholm University.

Globally, approximately 17 percent of mothers and nine percent of fathers suffer from mental health problems such as postnatal depression, also known as postpartum depression.

Based on both Swedish population register data and international literature, the thesis shows that generous parental leave—characterized by longer leave, paid rather than unpaid leave, or higher compensation levels—is associated with better mental health among parents.

Parental leave is a family policy measure that can help reduce financial stress during the transition to parenthood and support mental health. But in practice, the rules as they are designed can exclude parents who need the support the most.

Amy Heshmati, PhD Student, Department of Global Public Health, Karolinska Institutet

Her research points to injustices in the system. Parents with previous health problems are less likely to qualify for the more generous benefits under the parental insurance system. In one of the studies in the thesis, the researchers investigated whether current work and income requirements for generous parental leave benefits unintentionally disadvantage women with poorer health.

The study showed that mothers who had received hospital or outpatient care for a health problem before pregnancy were less likely to meet the requirements for more generous parental leave. The difference was particularly clear among women who had received care for mental health problems, especially if the care had continued for two consecutive years before pregnancy.

"Parents with previous health problems, especially mental health issues, often lack sufficient ties to the labor market to qualify for the most generous benefits," says Amy Heshmati.

To reduce inequality, Amy Heshmati believes it is important to support stable and secure employment for all and to ease the strict work-related requirements for generous parental leave. This can help more families start parenthood on equal terms and support the mental health of all new parents, not just the healthiest or those with permanent jobs, she argues.

"Parental leave is not just a family policy issue, but also a public health tool," concluded Amy Heshmati.

Source:
Journal reference:

Heshmati, A. F. (2025). Designed for equity? Studies on parental leave and the mental health of parents. Karolinska Institutet. Thesis. doi.org/10.69622/28869083.v1

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