May 25, 2023
Kathleen is a mother of two boys under the age of five. She loves being a mother, but the postnatal depression that began two years ago has made daily functioning and mothering challenging. She feels guilt and shame around her struggles and finds the new and unfamiliar conversations with her partner uncomfortable. Luckily, Kathleen lives near her mother and close friend, who provide social support. Still, she has yet to figure out how to navigate her postnatal depression as a wife and mother.
Kathleen’s story is not an unfamiliar one for many women and families. Mental health struggles take a toll on one’s overall health and ability to perform and function in daily life. They are known to impact family relationships, including marriage. However, many individuals may not fully consider how family structure – e.g., nuclear, single, step, blended or extended families – and mental health are connected. The connection between the two is quite strong; by supporting one, policymakers inevitably support the other.
It is widely known that family structures like marriage create significant physical and mental health benefits. Both married men and women live longer, healthier lives than those who are divorced, widowed or never married. For example, The Wall Street Journal highlighted research that found that over 25 years, married women – including those who later divorced – had a 35% lower risk of death than those who never married. They also were less depressed and lonely, happier, more optimistic, and “had a greater sense of purpose and hope.” The same kind of results exist for men – they live longer, have a lower risk of depression, and experience higher life satisfaction in comparison to those without partners. In contrast, those who do not marry experience a more significant negative health impact from social isolation, including an increased risk of premature death, than those who are socially isolated and widowed elderly persons. Marriage has also been shown to protect against loneliness, stress and alcohol abuse, and it can help increase self-control.
Does the opposite relationship also exist if marriage can be a buffer to mental health struggles? Can mental health status influence marriage?
The answer is yes. Mental health disorders can impact marriage, including the likelihood of getting married and staying married. A 2017 study assessed individuals twice over 10 years who had the most common mental health disorders; e.g., anxiety, depression, PTSD, bipolar disorder. They found that those with a mental health disorder at baseline assessment or onset after baseline assessment were associated with significantly greater odds of subsequent divorce. This was the case for those married at baseline or after baseline. They also found that individuals with a mental disorder onset after baseline had smaller odds of marriage or remarriage.
It is important to note that the research above speaks about risk and associations, not causal connections. However, the researchers note the possibility that the mental health issues they studied were a main driver of the marital outcomes they documented. If that causal connection exists, they note, then preventing those mental health problems would result in an estimated 6.7 million fewer divorces, and 3.5 million more marriages could have occurred in the U.S. over 11 years.
Of course, it is essential to recognize the reality that having mental health challenges does not predetermine marital outcomes. Moderating factors – like age, income and religiosity – exist for marriage and divorce. Further, a married couple truly committed to each other can make a strong marriage despite their personal or shared challenges.
However, the juxtaposition between mental health’s association and hypothetical causation on marriage raises new thoughts and questions. If mental health and marriage are connected, how much are they connected? How can we respond?
Our culture’s move from shrouded shame to more open conversations around mental health puts Utah in a unique position. Policymakers’ momentum toward addressing and treating mental health crises creates an extraordinary, unparalleled opportunity to also strengthen families like never before.
It may be wise for policymakers to review how many mental health policies and programs that have been instituted over the last few years directly stabilize and strengthen families. The state need not create family-only mental health policies to support the family institution. Instead, policymakers can consider whether current mental health policies and programs address mental health in ways designed to achieve policy goals regarding the institution of the family, such as incorporating elements tailored to benefit families and their mental health.
In other words, state mental health policies and programs offer the potential to accomplish two policy goals at once: improving Utahns’ mental health and strengthening the institution of the family. But that is only likely to happen if those policies and programs are intentionally designed to accomplish those complementary goals. If policymakers do so, they can help people like Kathleen while also serving the interests of Utahns broadly through helping Utah families.
Insights: analysis, research, and informed commentary from Sutherland experts. For elected officials and public policy professionals.
Family structure (like marriage) creates significant physical and mental health benefits.
Mental health disorders impact the likelihood of marriage and divorce.
Momentum around mental health is momentum to strengthen the family.
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