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Mental Health: A Presentation for Parents

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Managing Stress and Anxiety

Health Goal #7 I Will Seek Help If I Feel Depressed MENTAL AND EMOTIONAL HEALTH.

SECTION 7 Depression.

Understanding Mental and Emotional Health

Stress Chapter 3.

How does anxiety affect adults and children differently?

DEPRESSION AWARENESS AND SUICIDE PREVENTION Health Science II Mental Health Unit.

Year 11 Study Day Mental Health Workshop. What is Mental Health? The World Health Organisation defines Mental Health as: Mental health is defined as a.

Chapter 8 Managing Stress and Anxiety.

DO NOW: 1.In your own words, define stress. 2. List 5 things that stress you out. 3. How could these stressors lead to long term issues? 4. How could the.

Stress can be defined as our mental, physical, emotional, and behavioral reactions to any perceived demands or threats.

Mental and Emotional Problems In this lesson, you will Learn About… Types of mental and emotional problems. The warning signs of serious mental and emotional.

Depression and Suicide Chapter 4.3. Health Stats What relationship is there between risk of depression and how connected teens feel to their school? What.

Do-Now! Take a Stress worksheet from my desk Complete the worksheet

Stress. What is stress? O Stress is the way your body reacts to a difficult or demanding situation. O It can have positive and negative results. O A stressors.

ANXIETY DISORDERS: TODAY I WILL PROVIDE YOU INFORMATION ABOUT ANXIETY DISORDERS.SO SIT BACK AND RELAX: BIBLIOGRAPHY WILL BE AT THE END.

Presents Teen Depression and Anxiety Marcey Mettica, MS, LPC, RPT Michael Martino, MS, LPC Gillian de La Sayette, MS, LPC

STRESS MANAGEMENT Fitness for Life.

CCMS Parent Awareness Important information about Stress, Depression &

About project

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Mental Health Informational Meeting for Parents – 1 Hour

This is an opportunity for parents to be a part of the Mental Health National Dialogue. This informational meeting is time to have a conversation with parents about why mental health is an important issue and how we can improve mental health for our children.  This is a unique opportunity for parents to share perspectives – in a safe and welcoming environment – to engage in a dialogue about mental health issues and to address mental health issues facing children. This presentation provides appropriate mental health awareness for parents.

Join the GLOW family and make every step count

Bring some glowsticks, see some sights and unite with others to help raise funds for people living with mental ill health.

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Home / Help and information / Advice for parents and guardians

Advice for parents and guardians

Our resource library contains tools to help you confidently engage in conversations about mental health, emotional wellbeing and resilience with the young people in your life.

Videos to share with young people

Watch our series of animated videos based on the content of our young people’s programme. Each video focuses on a topic that young people have told us is important to them and support building their resilience through suggested tools and techniques.

Conversation guides

Having discussions with young people about mental health

Conversation Guide: Talking to young people about mental health

Conversation Guide: Talking to your friend about mental health

Parents and Carers Guide: How to support young people anxious about money

Having discussions with other parents and carers about young people’s mental health.

Using this guide, presentation and open letter will allow you to discuss your own knowledge and experience with others and share what works for you. This can be done online and in person

Guide for having discussions with other parents and carers

For someone with caring responsibilities for a young person, the idea of discussing emotional wellbeing can be difficult. But don’t be alarmed, this guide will help.

Presentation for having discussions with other parents and carers

Use this presentation to support the discussion guide when talking with other parents and carers.

An open letter from a parent

This letter is from a parent detailing their experience in dealing with a difficult time their child went through. It highlights the importance of having conversations and explains what to do if you are concerned about a young person in your life.

Resources to support young people

Mental Health UK have created resources you can share with the young people in your life to help them explore, understand and manage how they’re feeling post-pandemic.

Dealing with uncertainty

Disappointment is natural, but do you feel completely overwhelmed or ‘out of control’ when plans change unexpectedly? Being clear on what is inside and outside our control can help uncover resilience allowing us to adapt, rebuild, recover and recognise that we can also change and develop over time.

Building deeper relationships

After spending more time with the people in your home this year, and dealing with many changes to ‘normality’ we know it can feel pressured and easy to get angry with one another. This time can also be an opportunity to work on our relationships with those we live with.

About the resource library

The resources in this library have been developed using content from Bloom , Mental Health UK’s young people’s resilience programme.

It’s thanks to the fundraising efforts of colleagues across Lloyds Banking Group that has allowed us to develop Bloom. Their dedicated support has enabled the delivery of this essential programme, building young people’s mental health resilience across the UK and now empowering young people, parents, and carers closer to home.

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Child and Teenager Mental Health

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This fully customizable Google Slides and powerPoint template, designed in pleasing earth tones, adorned with boho leaf motifs and vivid images, intersperses style with substance. Use it to inform your audience of the importance of mental well-being and how to spot mental distress in children and teenagers early on. Detail the options available for helping them, be it through talk therapy or medication. This design is a one-stop solution for sharing invaluable insights on this critical subject matter!

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Transforming the understanding and treatment of mental illnesses.

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• Health Topics
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Child and Adolescent Mental Health

Why is children’s mental health important.

Mental health is an important part of overall health for children as well as adults. For many adults who have mental disorders, symptoms were present—but often not recognized or addressed—in childhood and adolescence. For a young person with symptoms of a mental disorder, the earlier treatment is started, the more effective it can be. Early treatment can help prevent more severe, lasting problems as a child grows up.

What are warning signs of mental health conditions in children?

It can be tough to tell if troubling behavior in a child is just part of growing up or a problem that should be discussed with a health professional. But if there are behavioral signs and symptoms that last weeks or months, and if these issues interfere with the child’s daily life at home and at school, or with friends, you should contact a health professional.

Younger children may benefit from an evaluation and treatment if they:

• Have frequent tantrums or are intensely irritable much of the time
• Often seem fearful or worried
• Complain about frequent stomachaches or headaches with no known medical cause
• Are in constant motion and cannot sit quietly (except when they are watching videos or playing video games)
• Sleep too much or too little, have frequent nightmares, or seem sleepy during the day
• Are not interested in playing with other children or have difficulty making friends
• Struggle academically or have experienced a recent decline in grades
• Repeat actions or check things many times (for example, repeatedly checking that a door is locked) out of fear that something bad may happen

Older children and adolescents may benefit from an evaluation if they:

• Have lost interest in things that they used to enjoy
• Have low energy
• Sleep too much or too little, or seem sleepy throughout the day
• Have periods of highly elevated energy and activity and require much less sleep than usual
• Spend more and more time alone, and avoid social activities with friends or family
• Diet or exercise excessively, or fear gaining weight
• Engage in self-harm behaviors (such as cutting or burning their skin)
• Smoke, drink alcohol, or use drugs
• Engage in risky or destructive behavior alone or with friends
• Have thoughts of suicide
• Say that they think someone is trying to control their mind or that they hear things that other people cannot hear

Mental illnesses can be treated. If you are a child or teen, talk to your parents, school counselor, or health care provider. If you are a parent and need help starting a conversation with your child or teen about mental health, find resources for families  from the Substance Abuse and Mental Health Services Administration. If you are unsure where to go for help, ask your pediatrician or family doctor or visit NIMH’s Help for Mental Illnesses webpage.

It may be helpful for children and teens to save several emergency numbers to their cell phones. The ability to get immediate help for themselves or for a friend can make a difference.

• The phone number for a trusted friend or relative
• The non-emergency number for the local police department
• 988 Suicide & Crisis Lifeline: 988

If you, your child, or someone you know needs immediate help, call or text the 988 Suicide & Crisis Lifeline   at 988 .

Latest news

July 30, 2024 • Media Advisory

Researchers at the National Institutes of Health (NIH) found that rates of preteen suicide (ages 8-12) have been increasing by approximately 8% annually since 2008.

Continue reading

July 17, 2024 • Press Release

The largest neuroimaging study of conduct disorder to date, with funding from NIH, has revealed extensive changes in brain structure among young people with the disorder. The largest difference was a smaller area of the brain’s outer layer, known as the cerebral cortex, which is critical for many aspects of behavior, cognition and emotion.

June 13, 2024 • Research Highlight

A tablet-based screening tool that analyzes children’s behavior in response to specific video clips shows promise for enhancing early autism screening, according to a study supported by NIMH.

Where can I learn more about child and adolescent mental health?

Featured health topics.

• Anxiety Disorders
• Attention-Deficit Hyperactivity Disorder (ADHD)
• Autism Spectrum Disorder (ASD)
• Bipolar Disorder
• Coping with Traumatic Events
• Disruptive Mood Dysregulation Disorder
• Eating Disorders
• Medications: Children and Teens
• Suicide Prevention

Featured brochures and fact sheets

Educational resources

Watch, download, and order a variety of videos, coloring books, and hands-on quizzes and activities related to children and mental health.

Download, read, and watch educational resources

Federal resources

• Child Mental Health   : The National Library of Medicine’s MedlinePlus offers resources to support children’s mental health ( en español  ).
• CDC Children’s Mental Health   : This Centers for Disease Control and Prevention provides information about children’s mental health, symptoms, treatment, data & statistics, child development, and more.
• Parents & Educators   : The National Institute on Drug Abuse provides science-based information and lesson plans about drug use, health, and the developing brain.
• Self-Harm   : Self-harm refers to a person harming their own body on purpose and it tends to begin in teen or early adult years. MedlinePlus offers resources to learn more about self-harm ( en español  ).
• Shareable Resources on Children and Adolescent Mental Health : Use these NIMH graphics and suggested social media messages to raise awareness about the importance of child and adolescent mental health.
• Teen Mental Health   : MedlinePlus provides resources about adolescent mental health ( en español  ).
• The  Individuals with Disabilities Education Act  consolidates information about how states and public agencies provide early intervention, special education, and related services for infants, toddlers, children, and youth with disabilities.
• The  Office for Civil Rights  provides information on federal laws that prohibit discrimination based on disability in public programs, such as schools.
• The  Center for Parent Information and Resources   lists Parent Training and Information Centers and Community Parent Resource Centers in each state.

Featured videos

Childhood irritability.

Learn about symptoms of irritability, why it's important to study irritability, NIMH-supported research in this area, and new treatments for severe irritability in youth.

Mental Health Minute: Stress and Anxiety in Adolescents

Got 60 seconds? Take a mental health minute to learn about stress and anxiety in adolescents.

Mental Health Minute: Attention-Deficit/Hyperactivity Disorder

Got 60 seconds? Take a mental health minute to learn about attention-deficit/hyperactivity disorder or ADHD.

Health hotlines

• 988 Suicide & Crisis Lifeline   :  The Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat at 988lifeline.org   . Para ayuda en español, llame al 988 .
• Disaster Distress Hotline  : People affected by any disaster or tragedy can call this helpline, sponsored by the Substance Abuse and Mental Health Services Administration, to receive immediate counseling. Call or text  1-800-985-5990  to connect with a trained professional from the closest crisis counseling center within the network.
• TXT 4 HELP   : Created by National Safe Place, this nationwide, 24-hour text service provides support for teens in crisis.
• More NIH Information Lines 

What are clinical trials and why are they important?

Children are not little adults, yet they are often given medicines and treatments that were only tested in adults. Research shows that children’s developing brains and bodies can respond to medicines and treatments differently than how adults respond. The way to get the best treatments for children is through research designed specifically for them.

Clinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.

NIMH supports clinical trials across the United States. Talk to a healthcare provider about clinical trials and whether one is right for your child. For more information, visit NIMH Clinical Trials – Information for Participants .

Last Reviewed:  March 2024

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

How to Support Mental Health for Parents and Teens

Strategies to help young people and caregivers cope with emotional obstacles..

Posted August 14, 2023 | Reviewed by Jessica Schrader

• What Is Depression?
• Take our Depression Test
• Find a therapist to overcome depression
• Parents are suffering anxiety and depression at about the same rate as teens.
• Depressed teens are about five times more likely than non-depressed teens to have a parent with depression.
• Over a third of teens feel they have no purpose or meaning in life.

It's not a secret that teenage mental health has been a national concern for a long time, with the rates of depression doubling over the past decade.

Earlier this year, U.S. Surgeon General Dr. Vivek Murthy issued an advisory entitled, " Social Media and Youth Mental Health ," digging into the complex world that teenagers and youth are dealing with online, especially when they are not emotionally prepared.

Although social media is the most common reason experts point to for teen depression , young people have also been struggling with academic stress , loneliness , as well as sleep deprivation.

Parents are suffering (too)

According to two nationally representative surveys in the U.S., about one-third of teens had a parent suffering from reported anxiety or depression.

Caregivers and parents are human, too. They are not only anxious about their child's well-being today in this troubled world, but they typically also have worries of their job, cost of living, and other grownup concerns. It can be extremely overwhelming.

The research shared some key points:

• Parents suffering from anxiety or depression are often wonderful parents despite these emotional challenges. However, depression and anxiety in parents have been linked to academic, emotional, and physical problems in children.
• Depressed teens are about five times more likely than non-depressed teens to have a depressed parent. Anxious teens are about three times more likely than non-anxious teens to have an anxious parent.
• A significant majority of parents are attuned to their teens' emotional states and perspectives, but many parents are not. This disconnect is strongly linked to depression and anxiety in both parents and teens.

Prevention strategies

We often read why people of all ages are suffering with anxiety and depression. Rarely have we taken time to find ways to help prevent these emotional obstacles.

The Caring for the Caregivers report shares some takeaways:

• Communication is key for building a healthy relationship. According to this study , 40% of teens want their parents to "reach out more and ask how [they're] really doing—and to really listen." Parents may need guidance on empathic listening skills—and that is something many people can benefit from.
• Educating yourself on mental health. The more you know, the more you can help yourself and your teenager . Learn the basic facts about anxiety and depression and when your teen needs professional treatment , as well as guidance in managing your own anxiety and depression.
• Cultivating meaning, hope, and purpose. Teen sadness is real today; 36% of teens surveyed reported little or no “purpose or meaning in life” and this absence strongly correlated with depression and anxiety. Parents can help by getting them engaged in activities that focus on others and goals that are both rich sources of meaning and purpose.

Just because we are grown up doesn't mean we don't need help emotionally. It's important to know when to ask for help and reach out to professionals or even friends or family members if you are feeling overwhelmed. Your actions speak volumes to your children—you are their greatest influence and role model.

To find a therapist, please visit the Psychology Today Therapy Directory .

Caring for the Caregivers: The Critical Link Between Parent and Teen Mental Health , Making Caring Common, Harvard Graduate School of Education (2023)

Key Substance Use and Mental Health Indicators in the United States , SAMHSA (2019)

Social Media and Youth Mental Health , HHS (2023)

Specification curve analysis shows that social media use is linked to poor mental health , Science Direct (2022)

Sue Scheff is a an advocate and family internet safety expert and the author of Shame Nation: The Global Epidemic of Online Hate .

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Saturday, October 26, 2024 9 am – 12 pm Hopkins Community Center

Growing Up: Caregivers & Daughters Connecting

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Growing up: families connecting.

A workshop for parents and children ages 9-12.  Growing up can be exciting, exhilarating, confusing and scary – all at the same time! Join us for a fun and informative three hour workshop that will take some of the mystery out of puberty and the questions out of adolescence. Prepare to laugh, create, question, learn and grow – TOGETHER!

Youth ages 9-12 and their caregiver, or other trusted adult, will engage in fun and thought-provoking activities that help them learn about: puberty, reproductive anatomy and development in bodies. We will learn what is normal (and great!) about growing up, how to have the best parent-child communication possible, and how to maintain or strengthen family bonds.

Staying Connected: Mental Wellbeing

This workshop will engage youth and their caregiver(s), or other trusted adult, in fun and thought-provoking activities that will help them understand more about mental health.  Topics include stress management, coping skills, and overall mental well-being.  Together, we will learn how to have open parent-child communication, maintain or strengthen family bonds, and how to use different tools and resources to support our mental health.

Parent Toolkits

Circles of wellness.

For caregivers with kids in grades 4 and up Length: 45-90 minutes

Explore the different dimensions of wellness in a non-judgmental space. Learn strategies caregivers can use to help their young person build resiliency and develop lifelong healthy habits.

Friendships, Relationships and Dating

For caregivers with kids in grades 4 and up Length: 90 minutes

Friendships are incredibly important to young people. How do we help our children foster healthy friendships and connection without overstepping their boundaries? Learn effective ways to start the conversation and help our young people navigate friendships, relationships and dating while respecting their autonomy.

Gender and Sexuality

For caregivers with kids in grades 4 & up length: 45-90 minutes.

Define common terms and concepts around gender and sexuality such as gender identity, heteronormativity, LGBTQIA+ and more. Ask questions and get answers in a supportive, non-judgmental setting. Connect with local and national LGBTQIA+ resources for youth and families.

Parenting in a Digital Age: Pornography

Learn the realities and considerations around youth exposure to explicit content. Leave with helpful tips on talking to your young person about sexuality and online use while promoting individual family values.

Parenting in a Digital Age: Social Media

For caregivers with kids in grade 4 and up length: 45-90 minutes.

Review what’s current and happening in the world of social media. Discuss  concerns such as screen time, cyber bullying and sexting. Explore effective ways to communicate with your young person and set technology boundaries as a family.

Parents as Sexuality Educators

Preparing yourself and your child for leaving home.

For caregivers with kids of any age Length: 45-90 minutes

Learn helpful tips for having age-appropriate conversations about sexuality. We will discuss sexuality (healthy relationships, boundaries, safety, confidence and more!), typical stages of sexual development for children and adolescents, family values, and how to use teachable moments to get the conversation started.  Connect with others and learn in a non-judgmental, supportive environment.

Stress Management and Self-Care

Caregiving can leave many feeling helpless, ineffective, and overwhelmed. Trying to juggle the demands of work, home, and parenting can prove to be difficult and stressful. Excessive stress can damage physical and emotional health. This class is designed to help parents manage the stress they face each day in healthy ways. The focus will be on parenting with mindfulness, prioritizing, self-care, and relaxation techniques that can be used on a daily basis to better manage and minimize stress.

To set up a presentation, please email us with the following information!

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• Location (Please include location and room number)
• Site Contact (Name, phone number for day-of, email)
• Presentation Date & Time
• Approximate Number of Attendees   (Attendees per Presentation)
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• Technology Needs *If attendees have access to iPads, laptops or smartphones

If you have any questions or are interested in learning more about our presentations, please contact Gabby:

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Promoting Mental Health and Well-Being in Schools:

A New Action Guide for School and District Leaders

Learn About Children’s Mental Health

Mental health in childhood means reaching developmental and emotional milestones, and learning healthy social skills and how to cope when there are problems..

Learn what is CDC doing to improve access to mental health care for children.

Learn what works best.

Get the facts! Learn about anxiety and depression in children.

Meet two families and hear about their experiences.

Learn how healthy, supportive school environments strengthen students’ emotional well-being.

Learn more about what everyone can do to support adolescent mental health and overall well-being.

Powerpoint Presentations

We have developed the following PowerPoint Presentations for use by community members and organizations, healthcare settings, and others for training purposes during discussions around caregiving and experiences of mental illness.

The first presentation reviews social issues that caregiving families face, such as stigma, and how old ideas of how families support each other can negatively influence public policy. The second presentation explores the idea of family systems and how ideas of families, caregiving, and coping with mental illness in the family have changed over time. Both presentations touch on relevant issues and present information in a way that is accessible to a broad audience. We have included presentation notes to provide further detail and guide discussions.

To download the PowerPoint slides, click below:

PowerPoint 1 > Families and Caregiving 1 – Social Issues slides

PowerPoint 2 > Families and Caregiving 2 – The Family System slides

To download the presentation notes, click below:

PowerPoint 1 > Families and Caregiving 1 – Social Issues notes

PowerPoint 2 > Families and Caregiving 2 – The Family System notes

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Addressing the Parent Mental Health Crisis

PSYC Professor Asserts that 'Caregivers Need Care, Too'  Recently, United States Surgeon General Dr. Vivek Murthy released a Surgeon General’s Advisory on the Mental Health and Well-Being of Parents , which outlines the critical levels of stress that American parents and caregivers are facing. 

According to the advisory, parents in the United States are struggling with overwhelm, loneliness and isolation—and both parents and children are facing unrealistic expectations exacerbated by social media. Parents are exhausted, and it most certainly affects their children. Andrea Chronis-Tuscano, the Joel and Kim Feller Endowed Professor in the Department of Psychology, has studied parent mental health—and has been offering support and strategies for parents and caregivers—for decades.  As a researcher with expertise in Attention-Deficit/Hyperactivity Disorder, a disorder with a strong genetic component, Chronis-Tuscano has also highlighted the strong links between the mental health and wellness of parents and their children. In the case of ADHD, Chronis-Tuscano said that parents with the disorder have trouble following treatment recommendations to provide structure and organization for their children if they struggle with the same executive function difficulties themselves.   “If we don’t help parents manage their own ADHD, they cannot help the child manage theirs,” Chronis-Tuscano said. “Parents in general tend to put their own needs aside for the benefit of their children, but if they are left depleted they cannot put energy into their kids.” Chronis-Tuscano is pleased to see that the surgeon general’s advisory has put the need for parental and caregiver support in the limelight.  “We have been talking about the youth mental health crisis since the pandemic. This advisory emphasizes that there is also a parent mental health crisis that needs attention,” Chronis-Tuscano said. “The more we highlight the impacts of parent mental health on child well-being, it will raise awareness of the dire need for clinical resources, research, funding and policy changes to support our nation’s parents.” Making Connections, Overcoming Barriers This new focus on the mental health of parents is not just a “nice-to-have” development, it is a critical component to improving the overall health and well-being of children and families.  

“We are finding that if you leave parents' mental health unaddressed, you can only get so far with helping the child,” Chronis-Tuscano said. “When we evaluate children, we need to ensure that the family health history screenings we typically gather for physical health conditions like  diabetes or heart disease, also ask about family history of mental health disorders.”  Citing that routine screening for postpartum depression in the parents is now routine at infant pediatric visits, Chronis-Tuscano suggests that parent mental health screenings might be expanded further into primary care visits.  Access to care and stigma around mental health are often barriers to care for many families. Chronis-Tuscano has worked with many healthcare settings and schools to make evidence-based screening and treatment for ADHD more accessible to youth and families who may never pursue treatment in mental health settings. Additionally, Chronis-Tuscano’s work helped parents and communities across the nation during the height of the COVID-19 pandemic, as she was one of the first researchers to offer practical tools and solutions to parents who were facing the unique challenges of keeping their children safe, educated and cared for during that isolating, confusing, dangerous time. Parents were putting their kids first during the pandemic, Chronis-Tuscano said, but that experience took a toll on parents and caregivers.  Sharing Strategies that Serve Parents Many of the strategies that Chronis-Tuscano shared with parents during the pandemic hold true today, especially as parents and kids alike continue to face stress at home, at school, online and beyond. “When our goal is to improve the mental health of children, we must continue to make the mental health of parents a priority,” Chronis-Tuscano said. Some strategies to promote health and well-being that Chronis-Tuscano encourages parents and caregivers to consider are:

• Prioritizing parent sleep, exercise, mental health and wellness
• Learning and practicing mindfulness
• Letting go of unhelpful comparisons, often brought on by social media consumption; thoughts like “She has it all together” or “I can’t keep up with what others are doing for their kids.” Allow room for imperfection.
• Prioritizing tasks that actually have to be done today, and what things aren’t as urgent. Ask for or hire support when possible. You cannot do it all!
• Having honest conversations with other parents in your social circle so you can support each other 

“It’s difficult for many parents and caregivers to make themselves a priority,” Chronis-Tuscano said. “You have to give yourself permission to get creative, to find ways to get more sleep and exercise, and to carve out time for yourself.” One parent that Chronis-Tuscano worked with found that she was faced with a familiar problem every day: the moment she arrived home from work, her family would meet her with questions, problems and requests. She decided to park a few blocks from her home, take a 20 minute walk to clear her mind, then get in her car and drive the rest of the way home, more prepared to face the demands of family life. “There are lots of little strategies that can make a big difference,” Chronis-Tuscano said. “Don’t fall into the trap of ‘all or nothing.’ You don’t have to turn into a marathon runner to improve your health—you can simply take a walk with a neighbor a couple of times per week. You don’t have to stop doing housework altogether—you can just choose to tackle one task a night versus three. You don’t have to drastically change your sleep schedule; even adding 30 extra minutes of sleep when you can can make a big difference.” An Uneven Landscape of Support Chronis-Tuscano emphasized that not all parents can equally afford to make even small changes to prioritize themselves. Socioeconomic factors can often come into play.  

The Surgeon General’s report highlighted that 25% of parents in America have financial concerns around meeting basic needs. Parents most in need of support are those living in poverty, and in dangerous neighborhoods. They are disproportionately stressed, isolated, and in need of policy changes and social support. “When you are a parent worried about putting food on the table, that’s a different kind of worry—you can’t just buy convenience meals at the grocery store to save yourself the stress of cooking or hire someone to help with the cleaning. If you are worried about safety in your neighborhood, it’s not so simple to go on a walk,” she said. “It is critical for these types of disparities to be acknowledged when it comes to considering policies and funding that can help to support parents and alleviate parental stress.” While it is good that this public health crisis is now getting more attention, Chronis-Tuscano said it is important to maintain awareness and momentum to pursue solutions. “We need to keep talking, to build up communities, even online communities,” Chronis-Tuscano said. “If nothing else, parents should recognize that when they can and do make themselves a priority, their families will benefit from their improved mental health and well-being, too.”  

Published on Tue, Sep 10, 2024 - 4:02PM

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• Published: 02 September 2024

Influence of parental attitudes and coping styles on mental health during online teaching in the COVID-19 pandemic

• Fang Cheng 1   na1 ,
• Lixian Chen 2   na1 ,
• Huabing Xie 3 ,
• Chenglan Wang 4 ,
• Ruonan Duan 4 ,
• Dihui Chen 5 ,
• Jincheng Li 1 ,
• Hongying Yang 1 &
• Lingjiang Liu 1  

Scientific Reports volume  14 , Article number:  20375 ( 2024 ) Cite this article

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During the COVID-19 pandemic, the online delivery model became the primary mode of education. With multiple pressures on society and families, mental health issues for parents have become particularly pronounced. Most of the current research has focused on the psychological state of education practitioners and children, with little attention to parents’ mental health issues. Therefore, this study explored the attitudes and coping styles of parents who experienced the process of their children being taught online over a long period and the factors influencing their mental health. This cross-sectional study was conducted between November 2021 and January 2022, using an anonymous online questionnaire to survey 1500 parents with children aged 6–13 years. The Chinese versions of the Patient Health Questionnaire Depression Scale (PHQ-9), the Parenting Stress Scale (PSS), the General Mental Health Questionnaire (GHQ-12), and the Brief Coping Style Scale (SCSQ), and a related factors questionnaire were used to survey the subjects. The normal distribution of the data was examined using the Shapiro–Wilk method. A multivariate regression analysis was conducted to identify factors significantly associated with parental mental health during the COVID-19 pandemic. Only 30.24% of parents agreed with online classes during the pandemic, and 52.28% used positive coping methods during stressful situations. Multivariate regression models identified significant factors associated with parental mental health: parent’s gender, child’s grade level, perceived stress about online classes, whether the child has ADHD, positive or negative coping styles, and subjective attitudes of support for online classes or not. The results of the study suggest that as online classes become more socially acceptable, it is necessary to be concerned about the risk of mental illness for parents and develop policies and interventions, especially for parents who adopt negative coping styles and endorse online classes. The focus should be on the stress of online classes on parents, improving the acceptance of online classes and psychological well-being, regulating the way parents deal with their children, and targeting subgroups of children with ADHD symptoms during the COVID-19 pandemic.

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Introduction.

Neoconiosis is a serious respiratory disease caused by infection with the novel coronavirus SARS-COV-2, known as COVID-19. Since 2019, COVID-19 has created a global pandemic, posing a significant threat to global public health 1 . Although the case fatality rate of COVID-19 has been estimated at 2–3%, which is considerably lower than that of Severe Acute Respiratory Syndromes (SARS) (approximately 10%) and Middle East Respiratory Syndrome (MERS) (approximately 40%) 2 , 3 , 4 , its impact has been profound. The virus has an extremely high transmission rate through the respiratory tract and close contact. As of 15 March 2020, COVID-19 has spread rapidly to 34 provinces and cities in China, while 144 countries/regions in five continents worldwide have reported cases of infection to varying degrees 5 . Thus, the COVID-19 pandemic in recent years has posed a significant challenge to the entire society and every individual’s life.

With the global spread of COVID-19, education in China and worldwide is facing a considerable challenge. Anticipating the high transmission rate of the virus, the crowded nature of public places such as campuses, and the low immunity profile of adolescents, the Chinese government enacted a series of responses, of which the use of online learning became a typical result of the COVID-19 pandemic 6 , 7 . While such initiatives have played a large part in preventing and controlling the pandemic, the impact on the parent and child side of the online delivery context is currently varied. Means et al. argue that online learning is an educational tool based on technological devices and the Internet in an era of rapid development 8 . Tallent-Runnels et al. are similarly optimistic that technological innovations and the continued growth of Internet accessibility can increase the motivation to learn online 9 . By contrast, however, Joshi et al. found that the pedagogical outcomes of online learning are controversial and that online learning directly contributes to the lack of face-to-face interaction between students and teachers 10 . Research has shown that effective online education requires high-quality means for designing and assessing online courses and that the operators, the teachers who deliver the courses online, are equally required in terms of proficiency in the use of Internet equipment, etc 11 , 12 . Unfortunately, many educational institutions lack a careful design and development process for the transition of teaching models 13 , and the online education experience during the pandemic has suffered from varying degrees of skepticism and rejection 14 .

During the COVID-19 pandemic, the conflict between the educational format and the students translated in different ways and to varying degrees into multifaceted stress and family conflicts for parents. On the one hand, online instruction placed greater demands on the technology of connecting to the Internet, as a great challenge for many economically disadvantaged households, especially with the economic depression induced by the pandemic. Students from different family backgrounds faced different feedback on their online learning, even with the same willingness to learn. In particular, younger students 15 , 16 , students from immigrant backgrounds 17 , and students from families with a low socioeconomic status 18 encountered more difficulties with distance learning. At the same time, the prolonged online mode of delivery poses a risk of increased exposure of learners to screens, impacting young people’s visual health. The lack of teacher and parental supervision is another challenge, especially for young learners. The disadvantaged, weaker learners, requiring more supervision and guidance from their elders, face significant difficulties in this learning environment. Beyond China, the pandemic and the closure of schools have profoundly affected the mental health of students worldwide 19 . Empirical studies in Bangladesh, China, France, Greece, the UK, and the USA have found that a large proportion of students suffer from varying degrees of mental disorders 20 , 21 , 22 . Many students experiencing the online delivery model over a long period report suffering from depression, anxiety, distress, and even suicidal thoughts 23 , 24 . Interestingly, this academic mental health problem of adolescents is, to some extent, transferred to their parents. Due to multiple issues, such as the inadaptability of the online mode of delivery and socioeconomic pressures, the academic burden of the children leads to different aspects of psychological feedback and coping for the parents.

Apart from the financial pressures on some families, parents and children in the context of their different formative years show very different attitudes and behavioral patterns toward the use and efficacy of electronic devices. This phenomenon has been particularly notable in online education during the COVID-19 pandemic. According to Soykan, parents emphasize the expected dangers of using technology for academic performance 25 . The epidemic forced parents to take on an additional task: supervising children during class, especially at basic and primary levels. Research on emergency distance learning during the COVID-19 pandemic has shown reduced interactions between teachers and students 26 , with the ability of students to learn independently and actively being crucial to students’ academic performance 27 . Hale, Troxel, and Buysse surveyed online teaching and concluded that parents were disappointed in helping their children focus and participate in virtual classrooms 28 . The study reported emotional and behavioral problems (i.e., anxiety, irritability, and distraction) observed by parents in their children and adolescents due to the epidemic 29 . These phenomena are particularly significant in adolescents with attention deficit hyperactivity disorder (ADHD). Some relevant studies have shown that adolescents with ADHD find it more difficult to adapt to the online teaching mode compared to their peers and often exhibit problems such as motivation problems and executive dysfunction 30 . ADHD children face significant challenges in online learning environments, including attention, task organization, and completion difficulties. The lack of face-to-face supervision and structure can make it harder for them to adapt and participate in learning activities. Additionally, the demands for self-discipline and time management in online learning pose further obstacles for these children 31 . Parents often bear different levels of pressure and mental health problems due to the problems associated with electronic equipment, anxiety about performance under online learning, and comprehensive social pressure during the COVID-19 pandemic. Research has shown that parents have greater responsibility and participation in their children’s learning in a distance learning environment than in regular classroom teaching 32 . This is a vicious circle of contradictions, wherein the various forms of pressure on parents may affect how students experience a new learning environment: the greater the pressure their parents feel, the more negative their views of distance learning become.

Under enormous social and economic pressure, the threat of COVID-19 infection, and the anxiety about children’s academic performance, parents experience mental health problems to varying degrees, which impact their social development. Studies have shown that home isolation, economic hardship, despair, and loneliness during the COVID-19 pandemic also increased the risk of mental illness and suicide 33 , 34 . Social isolation is usually closely related to physical and mental health issues 35 . Such mental health problems often have an inseparable relationship with the parents’ attitudes toward online teaching during the COVID-19 pandemic and the measures taken, which are often unavoidable. However, no scholars have yet reported on this phenomenon.

Therefore, this study investigated the parents’ sociodemographic information and mental health scoring variables (depression level, parenting stress, general psychological state, and coping style) to analyze differences in parental mental health and their related factors under different coping styles and attitudes toward online courses and explore how factors such as children’s ADHD symptoms, parents’ attitudes toward online courses, and parents’ coping styles affect parents’ mental health, in an attempt to provide effective guidance on parental mental health issues in the post-pandemic era and the emerging wave of online education.

Study design

This cross-sectional study surveyed the parents of young children. In the context of the COVID-19 pandemic and the prevalence of online classes, parents’ mental health variables, including depression levels, parental stress, general psychological status, and coping styles, were measured using an anonymous online survey, and their children’s ADHD symptoms were measured through parent ratings. Ethical approval for this study was obtained from the Ethics Committee of Kangning Hospital, Ningbo, Zhejiang Province, China (No. NBKNYY-2021-LC-1). A random sample of six primary schools in Ningbo, Zhejiang Province and Yuhuan County, Zhejiang Province were selected for data collection from November 2021 to January 2022. The purpose and content of the survey were explained to each respondent, and a digital informed consent form was provided for the study. All the respondents completed the questionnaire anonymously.

During this period, China adopted strict measures to control the spread of the COVID-19 36 . Especially in Zhejiang Province, including Ningbo City and Yuhuan County, the government and education departments quickly adapted to the changing situation, ensuring the continuity of education while prioritizing public health. Therefore, many schools in China still used online learning modes due to the ongoing impact of the COVID-19 pandemic. In primary schools in Ningbo City and Yuhuan County, Zhejiang Province, these regions benefited from relatively developed digital infrastructure. Schools were equipped with the necessary technology, allowing students to access the internet and use digital devices, although there were still differences. Platforms such as DingTalk, WeChat, and specialized educational applications were widely used for teaching and maintaining communication between teachers, students, and parents 37 , 38 . Concurrently, teachers received training on effectively using online teaching tools and methods. Additionally, a support system was established to assist parents and students in coping with the new educational model.

Participants

The questionnaires were completed anonymously in online class groups, and the participants were selected from different regions. The inclusion criteria were: (i) parents of children studying in Ningbo or Yuhuan County, Zhejiang Province, China, before the COVID-19 outbreak and currently, including primary school students and junior high school students; (ii) a child age of 6–13 years. Only parents participated in this survey; children did not directly participate.

Our study’s sample size was determined based on established principles in international questionnaire design. These guidelines suggest that the sample size should be approximately 5 to 20 times the number of items in the questionnaire to ensure adequate data representation and reliability 39 , 40 . Anticipating the possibility of non-responses or invalid questionnaires, which typically account for about 10% of the total surveys distributed 41 , we increased our target sample size by 10%. Therefore, the final sample size was set at 5.5 times the number of questionnaire items, ensuring that even with the anticipated rate of non-response or invalidity, we would still have a sufficiently large sample to maintain the robustness of our study’s findings. Given that our study comprised 153 items, the minimum sample size was calculated at 842 (153 items × 5.5).

In the end, 1500 questionnaires were distributed, and 1454 questionnaires were returned, yielding a response rate of 96.93%. Among these questionnaires, 138 had more than 30% missing data and logical errors and were thus recorded as invalid. There were 1,316 valid questionnaires, resulting in an effective completion rate of 90.51%.

Survey content

The general questionnaire comprised two main sections. The first part of the survey concerned sociodemographic information such as child grade, parent gender, parent education, online class approval or not, online class pressure, children’s ADHD type, and parents’ perceived source of their emotional impact (i.e., whether they believed their emotional impact was due to the pandemic or their child’s online classes). The specific question was: “If you feel that your emotions are affected, do you think it is due to the pandemic, your child’s online learning, or both?” Children’s ADHD type was rated by the parent version of the SNAP-IV rating scale 42 . The categories were as follows: attention deficit dominant (≥ 6 items on the Attention Deficit Subscale 2 or 3 only), hyperactivity/impulsivity dominant (≥ 6 items on the Hyperactivity/Impulsivity Subscale 2 or 3 only), and ADHD-C (≥ 6 items on both the Attention Deficit and Hyperactivity/Impulsivity Subscale 2 or 3).

The second part concerned the mental health rating variables, including depression level, parental stress, general psychological state, and coping styles, measured by the Patient Health Questionnaire Depression Scale (PHQ-9) (0–27), the Parental Stress Scale (PSS), the General Mental Health Questionnaire (GHQ-12) (0–12), and the Brief Coping Style Scale (SCSQ). These scales have exhibited good reliability and validity in previous studies 43 , 44 , 45 , 46 . These scales are classified as follows: PHQ-9: normal (0–4), mild (5–9), moderate to severe (10–14), and severe (20–27); PSS: normal (< 86), critical high (86–90), high (91–98), and very high (> 98); GHQ-12: high risk (98); GHQ-12 high (86o–3), and low risk (0–1); SCSQ: positive coping (coping tendency > 0), negative coping (coping tendency < 0), where coping tendency = positive coping standard score (Z score)—negative coping standard score (Z score), and the standard score is Z-transformed using the mean and standard deviation of positive coping style and negative coping style.

To ensure the reliability and consistency of the questionnaire results, psychiatrists explained the purpose of the survey and administered it to participants. A pre-test was conducted before the main survey to explore the questionnaire’s psychometric properties, such as reliability and validity. The pre-test involved a small group of participants similar to the main study’s target population. After completing the pre-test questionnaire, the researchers collected the responses, entered the data, and performed an initial analysis to identify any issues with the questionnaire items. This process helped refine the questionnaire and ensure the quality of the answers in the main survey.

Data analysis methods

After logic checking and proofreading, we used R-4.2.1 (an open-source programming language) and Rstudio for Windows (an open-source IDE) to process and analyze the data. We first conducted a descriptive analysis of the social demographic characteristics of the participants (Table 1 ) and a descriptive analysis of the continuous variables (PSS, PHQ-9, GHQ-12, and SCSQ) (Table 2 ).

The Shapiro–Wilk test 47 was used to test the normality of each variable. In addition, Spearman’s rank correlation analysis 48 was used to investigate the correlations between the variables (Table 3 ). Spearman’s rank correlation analysis was adopted because it is applicable to data with non-normal distribution and can effectively evaluate the monotonic relationship between two variables. Its results are more reliable than the chi-squared test, especially when the data are skewed. Ultimately, this study conducted a univariate intergroup analysis on each variable based on whether the parents agreed to online classes and the parents’ coping styles (Table 4 ). The purpose was to explore the differences in parental mental health and related factors among different groups and determine possible influencing factors.

In the multiple regression analysis, we examined the impact of various independent variables on the psychological health of parents (i.e., PSS, PHQ, and GHQ) under different coping styles and attitudes toward online courses. Specifically, we studied the effects of different coping styles (negative or positive) on parental mental health and related factors (Table 5 ). Additionally, we explored how different attitudes toward online courses (disapproving vs. approving) influenced parental mental health and related factors (Table 6 ). The purpose of the multiple regression analysis was to reveal the impact of each variable on the parents’ mental health and related factors and provide a basis for interventive measures.

The main objectives of this study were to analyze the differences in parental mental health and its associated factors across coping styles and attitudes toward online classes, as well as to explore how factors such as children with ADHD symptoms, parental attitudes toward online classes, and parental coping styles affect parental mental health. We hope to provide strong references and recommendations for improving parental mental health through these analyses.

It is particularly noteworthy that this work considered p -values of < 0.05 statistically significant.

Sociodemographic characteristics

The survey, which included 1316 participants, revealed that only a minority of parents supported online classes during the pandemic. The majority adopted positive coping methods during stressful situations. Table 1 presents detailed demographic information about the parents and their children, including grade levels, gender distribution, age ranges, and educational attainment. Additionally, Table 1 outlines the parents’ perceptions of online classes, their levels of stress, sources of emotional stress, and the types of ADHD diagnosed in their children.

The distribution and correlations among variables

Table 2 presents the distribution characteristics of scores on the PSS, PHQ-9, GHQ-12, and SCSQ scales, indicating that the scores did not conform to a normal distribution regarding skewness, kurtosis, and extreme value distribution ratios.

Table 3 details the correlations between sociodemographic characteristics and mental health variables, highlighting several significant associations. Key findings include: (1) Parental stress correlated significantly with the child’s grade and parent’s gender, educational level, approval of online classes, stress due to online classes, and sources of emotional stress; (2) PHQ-9 scores showed significant associations with the child’s grade and parental age, education, approval of online classes, online class stress, and sources of emotional stress; (3) GHQ-12 scores were significantly linked to the child’s grade and parental age, education, online class recognition, online class stress, and emotional sources; (4) SCSQ scores correlated with parental gender, approval of online classes, and stress from online classes; (5) ADHD was significantly associated with the child’s achievements and parental gender, recognition of online classes, stress from online classes, and emotional sources.

These correlations provided the basis for the subsequent analysis and are comprehensively detailed in Table 3 .

The severity of measurements and associated factors

Table 4 shows the results of single-factor analyses of survey data, highlighting significant differences based on parental approval of online classes and the type of coping strategy adopted. The key findings are: (1) Parental approval of online classes: Significant differences were observed between parents who disapproved and those who approved of online classes in terms of online class pressure, emotional sources, and scores on the PSS, PHQ-9, and GHQ-12 scales ( p  < 0.001 for all); (2) Coping strategies: Parents adopting positive coping strategies (SCSQ > 0) showed significant differences in PSS, PHQ-9, and GHQ-12 scores compared to those using negative coping strategies (SCSQ < 0), with p < 0.001 for all comparisons. No significant differences were found in terms of sociodemographic characteristics or other factors. These analyses underscore the impact of online class approval and coping strategies on parental stress and mental health, as detailed in Table 4 .

The study used multiple regression to analyze parental coping styles, attitudes toward online courses, and their impact on mental health, including the PSS, PHQ-9, and GHQ-12 dimensions, as detailed in Tables 5 and 6 . The findings are summarized below.

The results from Table 5 are as follows: For negative coping, PSS scores were significantly associated with parental gender, online classroom stress, and ADHD type. Female parents and parents experiencing lower stress levels in online classrooms had lower PSS scores. Parents of children without ADHD symptoms also had lower PSS scores compared to those with the combined ADHD type; PHQ-9 scores were significantly associated with the child’s grade and parental education, online classroom agreement, and emotional source. Higher PHQ-9 scores were noted among parents of older children, parents with higher education, those agreeing to online classes, and those influenced by both COVID-19 and online learning. GHQ-12 scores were significantly associated with the child’s grade and parental education, online classroom agreement, and emotional source. Higher GHQ-12 scores were found among parents of older children, parents with higher education, those agreeing to online classes, and those influenced by both COVID-19 and online learning. For positive coping, PSS scores were associated with parental education and online classroom stress. Parents with higher education and those with lower online classroom stress had lower PSS scores. PHQ-9 scores correlated with the child’s grade, online classroom stress, and ADHD type. Parents of older children, those with lower online classroom stress, and those with children without ADHD symptoms had lower PHQ-9 scores. GHQ-12 scores correlated with online classroom stress and ADHD type. Parents with lower online classroom stress and those with children without ADHD symptoms had lower GHQ-12 scores.

Table 6 further compares the results of multiple regressions under different attitudes toward coping with online classes.

Concerning PSS scores, among parents disapproving of online classes, those aged 38–45 had higher scores, while college-educated parents had lower scores. Among approving parents, moderate online classroom stress and higher SCSQ scores were associated with lower PSS scores. Concerning PHQ-9 scores, among disapproving parents, those with a postgraduate degree had higher scores. Among approving parents, higher scores were noted for parents of older children and those with high online classroom stress, while higher SCSQ scores were linked to lower PHQ-9 scores. Regarding GHQ-12 scores, among disapproving parents, those with children having attention deficit ADHD had higher scores. Among approving parents, higher scores were observed for parents of older children and those with high online classroom stress, while higher SCSQ scores correlated with lower GHQ-12 scores.

These analyses illustrate the complex relationships between parental coping styles, attitudes toward online classes, and various mental health dimensions. Detailed results are presented in Tables 5 and 6 .

Since the gradual outbreak of COVID-19 in late 2019, the virus has exhibited an unimaginably high level of infectiousness 49 . As of 3 April 2020, there had been at least 52,869 deaths and 10,066 confirmed cases of COVID-19 infection; by 18 May 2020, the number of confirmed cases had increased to 4,679,511, with 315,005 deaths. Frighteningly, these numbers rapidly increased, with many people having secondary infections 50 . The rapid spread of COVID-19 worldwide posed a serious challenge to the entire human population on many fronts: health, economic, environmental, and social. The impact on the education sector has been particularly significant: to avoid the mass gathering of young students, most schools were forced to opt out of the face-to-face mode of delivery and instead turn to online learning. Although online learning is not new, this massive, long-term paradigm shift presented significant challenges for children and parents alike 51 . Sun et al. indicated that students subjected to the online delivery mode for a long time since the spread of COVID-19 were more likely to fall behind in their grades and be affected by various aspects of psychological stress 52 . The impact on pupils can easily be passed on to parents to varying degrees, becoming a psychological burden and challenge. However, much of the current research is based on the perspective of educators and children, often ignoring the attitudes and mental health factors of the parents.

In a multifactorial study of the impact of parental attitudes and coping styles on mental health in the context of online delivery during the COVID-19 pandemic, parents’ agreement with online delivery was only 30.24%, and 52.28% adopted positive coping styles in times of stress. We found that the significant factors for parental mental health (measured as PSS, PHQ-9, and GHQ-12 quantitative values) were parental gender, the child’s grade, perceived stress about online classes, whether the child has ADHD, positive or negative coping styles, and subjective attitudes toward supporting online classes. This study separately examined the influence of individual child characteristics and subjective parental attitudes and behavioral patterns on their mental health.

Individual child characteristics

The analysis of children’s ADHD subtypes revealed that the regression coefficients for the quantified values of parental psychological problems were significantly lower for parents of children without ADHD compared to parents of children with mixed ADHD symptoms (Tables 5 and 6 ). However, it is noteworthy that the regression coefficient was positive when parents disagreed with online classes, which might be due to subjective negative parental attitudes masking the impact of the child with ADHD on the parent’s mental health. ADHD, whose main symptoms are inattention, hyperactivity, and impulsivity, is one of the most common psychiatric disorders, with a prevalence of 4‒6% in children and adolescents 53 , 54 and 5.6% in this study (Table 1 ). Interestingly, the mental health impact of children with ADHD on their parents was similar across time. One study on the parents of children with ADHD found that such parents were at greater risk of developing psychopathology 55 . This type of phenomenon showed a more pronounced trend during the COVID-19 pandemic in the context of a long-term home isolation policy and multiple social pressures. The unfamiliarity with electronic devices, concerns about performance in online classes, and the hyperactivity and inattention of children with ADHD symptoms continue to impact parents’ psychological defenses, ultimately leading to a range of mental health problems. Research has shown that the majority of children with ADHD (40‒60%) exhibit both oppositional defiant disorder (ODD) and/or conduct disorder 56 . This oppositional psychology or behavior toward elders was often amplified in the online mode of instruction during the COVID-19 pandemic due to the long hours spent together.

In addition, this study found significant effects on parents’ mental health when their children were in the middle and upper grades. Interestingly, the higher grades did not increase parental stress but instead increased parental depression and reduced the general psychological state of GHQ-12 scores of the parents (Tables 5 and 6 ). In a study on the consistency of parental anxiety with children, it was reported that in 76% of the parents in the sample who suffered from depressive psychological problems, the children tended also to have some mental health problems. This was often an indirect link, and this effect was not found in younger children 57 . In the context of the COVID-19 pandemic, the online mode of delivery led to varying degrees of adaptation and concerns about academic performance, often creating a state of stress and anxiety among students, particularly in the context of the long-term home isolation policy. Often, as students progress through the grades, the burden of schoolwork and the pressure to progress to higher education intensifies this phenomenon. Parents who either respond positively or negatively to online classes, with some threat to employment, salary packages, etc., all expressed concerns about online classes, especially when their children were at some critical point in their senior years. Several studies have found that the correlation between psychological problems such as parental and child depression increases with the child’s age 58 , 59 . Even parents who have some reservations about the online mode of instruction for their younger children show some tolerance and emotion compared to their attitudes toward the online instruction of their middle and upper school children, contributing to a relatively relaxed state of mind and psychological situation. Although parents who experience depression and other psychological states in the face of heavy academic pressure on their children in the upper grades are often less able to cope with the difficulties of the upper grades and the gradual expression of their children’s sense of autonomy, the parental pressure in this situation is not significant 60 , 61 .

Parents’ willingness to respond in a subjective way

This study focused on the impact of long-term online teaching of children on parental mental health during the COVID-19 pandemic, specifically regarding parents adopting two distinctly different behavioral approaches, negative or positive. The univariate group comparisons in Table 4 show that parental adoption of positive coping resulted in significantly lower mean scores on the PSS, PHQ-9, and GHQ-12 (109.37–98.66, 11.33–10.11, and 3.17–2.57). During the global spread of the virus, the fear of getting sick inspired more negative emotions dominated by stress, anxiety, and other psychological disorders 62 . A study in Iran showed that 34.8%, 32.2%, and 29% of the adult population in the Yazd region had negative psychological symptoms such as stress, anxiety, and depression, respectively, during the COVID-19 pandemic 63 . Health concerns, accompanied by economic stagnation and various aspects of the child’s schooling, have resulted in strong negative psychological feedback from parents during the COVID-19 period, especially in a negative way. With this negative behavioral approach, accompanied by a distrust of electronic devices and online delivery modes, parents often voice doubts about the effectiveness of their children’s lessons. However, the parental pressure and anxiety brought about by this pandemic can easily demotivate students and discourage them from learning 64 . Children who lose interest in learning will eventually regress in the long-term online mode, and this vicious circle will further feed parents’ frustration with the online mode. As shown in Table 5 , in the multiple regression results for parental mental health and its correlates under different coping styles, we found an interesting phenomenon: among parents who maintained a negative coping style, men tended to show high levels of parental stress significance (i.e., a decrease of 2.03 for women compared to men), and the parents with a positive coping style did not show significant gender-differentiated behavior. In addition, the lower the level of stress parents experienced from online classes was, the lower the regression coefficients were for the quantitative values of parental psychological problems. Furthermore, parents who maintained a positive coping style had higher regression coefficients compared to those with negative coping styles (Table 5 ). Active parental involvement in family education is crucial to the child’s development 65 , and it is relatively easier to maintain a healthy psychological level in such a benign parenting relationship. Pratama et al. showed through a study of parental feedback in the face of home-based online classes during the pandemic 66 that positive parental coping in the face of a long-term online delivery model is an effective safeguard for advancing children’s learning progress, which forms, to some degree, a virtuous cycle.

It is also worth noting, as shown in Table 4 , that subjective parental disapproval of online instruction resulted in significantly lower means scores on the PSS, PHQ-9, and GHQ-12 (108.85–102.27, 11.45–10.45, and 3.41–2.66). Thus, in addition to the differential impact of how parents respond to long-term online classes, the subjective willingness or unwillingness to support online classes showed a similarly significant impact. Although some have argued that parental involvement in the child’s learning experience during COVID-19 is unprecedented, the fact is that parental behavioral interference and even subjective attitudes have a profound impact on the child’s learning and have done so for decades 67 , 68 , 69 . Plowman et al. showed that children’s online learning requires more subjective support and assistance from parents than formal supervision 70 . Our analysis revealed that when parents reported subjective agreement with online classes, their perception of low stress associated with these classes was more negatively correlated with levels of psychological well-being than when they disagreed with online classes (as rated by the PSS, PHQ, and GHQ) (Table 6 ). A 2019 study found that parents’ attitudes toward their children’s online learning affected the quality of their children’s learning 71 and that children’s learning often feeds back to some extent on the parents’ mental health state. The above phenomenon may be because the expectations of these parents are more aligned with reality. They may have a negative perception of online delivery, so their expectations of its effectiveness are lower. As a result, they may feel less stress and disappointment when reality meets their expectations. Conversely, parents who identify with online delivery may have higher expectations and feel more stress and disappointment when reality does not meet those expectations.

Finally, parents should show a more tolerant and supportive attitude to the online teaching model for students during COVID-19, even in the face of the many stressors that arise at home. With the rapid development of technology and the spread of new electronic devices in modern society, this online mode of delivery will not just be a significant feature of the COVID-19 period but will gradually become more common in the future. A range of theories derived from motivation research, such as self-determination theory 72 , expectancy-value theory 73 , and achievement goal theory 74 , suggest that active involvement in children’s learning processes, with the intervention of a facilitator and the provision of some external motivators, can effectively address the psychological factors that influence learner motivation, engagement, and learning. Therefore, it is only by being more optimistic and accepting of new things and by motivating their children to varying degrees that parents can guide their children to adjust to their mental health.

Strengths & limitations

We analyzed the differences in parental mental health and its correlates across coping styles and attitudes toward online classes and explored how factors such as children with ADHD symptoms, parental attitudes toward online classes, and parental coping styles all affect parental mental health. The results suggest that, at a time when online delivery is becoming socially acceptable, attention must be paid to the risk of mental illness it poses to parents. In addition, policies and interventions need to be developed to increase parental acceptance of online delivery. It is hoped that this study can provide effective guidance on parental mental health issues in the post-pandemic era and the emerging wave of online education. In addition, the results of this study are based on a relatively large sample drawn from a randomized whole group and may partially reflect the mental health characteristics of parents of school-aged children aged 6‒13 years in China between pandemics and, to some extent, represent the sociological characteristics of parents suffering from mental health problems under the pressure of online delivery. The present results may serve as a reference for countries with similar cultural backgrounds.

However, our study has several limitations. First, this study is a cross-sectional survey limited in its ability to provide longitudinal judgments of the development of parental mental disorder characteristics, and longitudinal prospective observations may be considered in the future. In addition, the parenting stress, general mental health, and depression scales included in the survey contain a wide range of behaviors of varying clinical relevance, and some atypical behaviors may not be captured by these scales. Furthermore, there is a significant imbalance in group sizes between children with normal ADHD and those with other types of ADHD, which might affect the generalizability and precision of our findings. This imbalance highlights the need for larger sample sizes for each ADHD subtype in future research. Despite combining all other types of ADHD into one group for analysis, the imbalance remains, and this issue should be addressed in future studies.

Few reports are available on parents’ mental health factors against the background of long-term online teaching during COVID-19. Therefore, in this study, we conducted a multifactorial survey on the impact of parents’ attitudes and coping styles on their mental health in this context. The results showed that during the COVID-19 pandemic in China, facing the long-term online teaching mode, parents of senior children and children with ADHD showed a higher risk of depression and other psychological disorders due to excessive worry and anxiety. In addition, there was a close relationship between parents’ subjective attitudes and behavioral patterns and their mental health status: parents who adopted a positive coping style were relatively less susceptible to the negative impact of both the pandemic and online teaching, so they gradually adapted to their children’s online teaching mode and provided guidance to varying degrees. Subjectively, parents who did not agree with online teaching had a better mental health status compared to parents who agreed with online courses. The findings of this work can provide practical guidance on parental mental health issues in the post-pandemic era and the emerging wave of online education, with a focus on the stresses that online classes induce in parents, improving parental acceptance of online classes and their mental health, and providing further psychological relief measures and health programs for different groups of students and parents.

Data availability

The data that support the findings of this study are available on request from the corresponding author, [Liu], upon reasonable request.

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Acknowledgements

We gratefully acknowledge the support of the Medical Science and Technology Plan Project in Ningbo, Zhejiang Province, China (2020Y22), as well as supports from the Medical and Health Technology of Zhejiang Province, China (2021KY330) and the Ningbo Natural Science Foundation, Zhejiang Province, China (202003N4262).

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These authors contributed equally: Fang Cheng and Lixian Chen.

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Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China

Fang Cheng, Jincheng Li, Hongying Yang & Lingjiang Liu

The Second People’s Hospital of Yuhuan, Zhejiang, China

Lixian Chen

Department of General Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China

Huabing Xie

Huizhen Academy, NingBo, Zhejiang, China

Chenglan Wang & Ruonan Duan

Gaoqiao Central Primary School, Haishu, Ningbo, Zhejiang, China

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F.C., L.C., and H.X. conceived and designed the experiments. C.W. and R.D. performed the experiments and collected data. D.C. and J.L. analyzed the data. H.Y. and L.L. contributed to the writing of the manuscript and provided critical revisions that addressed important intellectual content. All authors discussed the results and implications and commented on the manuscript at all stages. *H.Y. and L.L. also served as corresponding authors, overseeing the project coordination and ensuring the integrity of the work from inception to published article. F.C. and L.C. contributed equally to this work due to L.C. significant contributions in completing the revisions.

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This survey was conducted following the principles of the Declaration of Helsinki. The following information was supplied relating to ethical approvals (i.e., approving body and any reference numbers): The Ningbo Kangning Hospital granted Ethical approval to carry out the study within its facilities (Ethical Application Ref. No.: NBKNYY-2021-LC-1, 2021.3.15–2024.3.14).

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Cheng, F., Chen, L., Xie, H. et al. Influence of parental attitudes and coping styles on mental health during online teaching in the COVID-19 pandemic. Sci Rep 14 , 20375 (2024). https://doi.org/10.1038/s41598-024-71314-5

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• Mothers — and fathers — report mental, physical health declines

Fathers (82%) were significantly more likely to say they could have used more emotional support than mothers (68%).

Since March 2020, life has changed radically for parents of children under 18. Not only have they had to deal with the universal pandemic disruptions on their work and social lives, but also grapple with the pandemic’s impact on their children. Nearly half of parents (48%) said the level of stress in their life has increased compared with before the pandemic. More than 3 in 5 parents with children who are still home for remote learning (62%) said the same.

Similarly, while slightly more than 3 in 10 adults (31%) reported their mental health has worsened compared with before the pandemic , nearly half of mothers who still have children home for remote learning (47%) reported their mental health has worsened; 30% of fathers who still have children home said the same. And while 3 in 4 parents (75%) said they could have used more emotional support than they received since the pandemic started, fathers (82%) were significantly more likely to say they could have used more emotional support than mothers (68%).

When it comes to seeking treatment, parents were more likely than those without children to have received treatment from a mental health professional (32% vs. 12%) and to have been diagnosed with a mental health disorder since the coronavirus pandemic began (24% vs. 9%). Here, too, fathers were more likely than mothers to have received mental health treatment (38% vs. 26%) and to have been diagnosed with a mental health disorder since the start of the pandemic (29% vs. 19%). Additionally, more than half of parents (54%) said they feel like their children could have benefited from receiving treatment from a mental health professional since the pandemic started, particularly parents of tweens ages 8–12 (63%).

Regarding physical changes, 8 in 10 fathers (80%) reported unwanted changes in weight, compared with 66% of mothers since the start of the pandemic. Specifically, 55% of fathers reported gaining weight, with an average weight gain of 45 pounds (median of 20 pounds). On the other hand, 47% of mothers said they gained weight, with an average weight gain of 27 pounds (median of 15 pounds).

Fathers (87%) also were more likely than mothers (77%) to report sleeping more or less than they wanted to since the pandemic started and to say they are drinking more alcohol to cope with stress (48% of fathers vs. 29% of mothers).

How parents can support their children and themselves, and stay healthy

• Practice self-care in 15- or 30-minute increments throughout the day and help your kids to do the same. This can include taking a short walk, calling a friend or watching a funny show.
• Stay connected with each other, your friends and family. This will help you build emotional resilience so you can support the needs of your children.
• Try hosting device-free time for the whole family, where you make and eat dinner together or play a board game. Children are more likely to talk about their experiences while engaging in an activity. ⁠
• Stress in America

Survey sections

• One year later, a new wave of pandemic health concerns
• Essential workers more likely to be diagnosed with a mental health disorder during pandemic
• Hispanic adults most likely to report physical impacts of stress; Black Americans concerned about life after the pandemic
• Young Americans continue to struggle
• Coronavirus stress: Majority of Americans never imagined pandemic would last this long

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