RAND Corporation, Santa Monica, California.
Department of Economics, Elon University, Elon, North Carolina.
JAMA Netw Open. 2024 May 1;7(5):e2413884. doi: 10.1001/jamanetworkopen.2024.13884.
Although new parents' mental health is known to decline, less is known about changes in therapy attendance, especially among military service members.
To investigate changes in therapy attendance among new parents and by parental leave length.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study of US Army and Navy service members from January 1, 2013, to December 31, 2019, compared parents' monthly therapy attendance with matched nonparents' across childbirth and compared mothers' weekly therapy attendance before vs after returning to work. Eligible monthly sample members included service members with first births from January 1, 2014, to December 31, 2017, and 12 months of data before to 24 months after birth and nonparents with 36 months of data. Eligible weekly sample members included mothers with first births from January 1, 2013, to June 30, 2019, and data from 12 months before to 6 months after birth and nonparents with 18 months of data. Data analysis was performed from July 1, 2023, to January 15, 2024.
Those exposed to parenthood had no prior children, acquired a dependent younger than 1 year, and, for mothers, had an inpatient birth. Unexposed matches did not add a dependent younger than 1 year.
Monthly counts of mental health therapy sessions and any therapy sessions (weekly).
The monthly sample included 15 554 193 person-month observations, representing 321 200 parents and matches, including 10 193 mothers (3.2%; mean [SD] age, 25.0 [4.9] years), 50 865 nonmother matches (15.8%; mean [SD] age, 25.0 [5.0] years), 43 365 fathers (13.5%; mean [SD] age, 26.4 [4.8] years), and 216 777 nonfather matches (67.5%; mean [SD] age, 26.4 [4.8] years). The weekly sample included 17 464 mothers. Mothers went to 0.0712 fewer sessions at 1 month post partum (95% CI, -0.0846 to -0.0579) compared with 10 months before birth. Fathers went to 0.0154 fewer sessions in the month of birth (95% CI, -0.0194 to -0.0114) compared with 10 months before. Parents with preexisting treatment needs had larger decreases in treatment. Weekly therapy attendance increased by 0.555 percentage points (95% CI, 0.257-0.852) when mothers returned to work from 6 weeks of leave and 0.953 percentage points (95% CI, 0.610-1.297) after 12 weeks of leave.
In this cohort study of new parents, therapy attendance decreased around childbirth, especially among parents with prior mental health needs and mothers with longer maternity leaves. These findings suggest that more accessible treatment, including home visits or telehealth appointments, is needed.
尽管新父母的心理健康状况众所周知会下降，但对于治疗参与度的变化，尤其是在军人服务成员中，了解得较少。
调查新父母的治疗参与度以及父母产假长短的变化。
设计、地点和参与者：这是一项在美国陆军和海军服务成员中进行的队列研究，从 2013 年 1 月 1 日至 2019 年 12 月 31 日，将分娩前后新父母每月的治疗出勤率与匹配的非父母进行比较，并比较母亲返回工作岗位前后每周的治疗出勤率。每月样本成员包括 2014 年 1 月 1 日至 2017 年 12 月 31 日首次生育的服务成员，以及分娩前 12 个月和分娩后 24 个月的数据；非父母成员则包括 36 个月的数据。每周样本成员包括 2013 年 1 月 1 日至 2019 年 6 月 30 日首次生育的母亲，以及分娩前 12 个月和分娩后 6 个月的数据，非父母成员则包括 18 个月的数据。数据分析于 2023 年 7 月 1 日至 2024 年 1 月 15 日进行。
那些有生育经历的人是指没有其他孩子的人，他们获得了一个不满 1 岁的受抚养人，对于母亲来说，她们有住院分娩。未暴露的匹配人员没有添加不满 1 岁的受抚养人。
心理健康治疗次数的每月计数和任何治疗次数（每周）。
每月样本包括 15554193 人月观察，代表 321200 名父母和匹配人员，包括 10193 名母亲（3.2%；平均[SD]年龄 25.0[4.9]岁）、50865 名非母亲匹配人员（15.8%；平均[SD]年龄 25.0[5.0]岁）、43365 名父亲（13.5%；平均[SD]年龄 26.4[4.8]岁）和 216777 名非父亲匹配人员（67.5%；平均[SD]年龄 26.4[4.8]岁）。每周样本包括 17464 名母亲。与分娩前 10 个月相比，产后 1 个月母亲的治疗次数减少了 0.0712 次（95%CI，-0.0846 至-0.0579）。与分娩前 10 个月相比，父亲在分娩当月的治疗次数减少了 0.0154 次（95%CI，-0.0194 至-0.0114）。有预先存在的治疗需求的父母治疗减少幅度更大。母亲休 6 周和 12 周产假后，每周治疗参与度分别增加了 0.555 个百分点（95%CI，0.257-0.852）和 0.953 个百分点（95%CI，0.610-1.297）。
在这项针对新父母的队列研究中，治疗参与度在分娩前后下降，尤其是在有先前心理健康需求的父母和产假较长的母亲中。这些发现表明，需要更多便捷的治疗，包括家访或远程医疗预约。
