Parental stress during and after the COVID-19 pandemic in families of children with mental disorders

Background: The COVID-19 pandemic negatively affected parental stress, which is known as an important factor of children’s mental health. We investigated parental stress during and after the pandemic in parents of children with pre-existing mental health problems, and whether the type and severity of mental health problems of their children were related to levels of parental stress. Methods: We collected parent-reported data on parental stress and child internalizing and externalizing problems at seven timepoints from April 2020 until April 2023, using a repeated cross-sectional design. Children received care in an academic child and adolescent psychiatric centre (N 2,177; age 8-18). Parental stress was assessed with the parenting stress questionnaire and data on children’s internalizing and externalizing problems were assessed with the Brief Problem Monitor. Results: Parental stress increased over time during the first two years of the COVID-19 pandemic, and after a significant decrease at the end of the pandemic, there is a steep increase again a few months later, post-pandemic. We found a significant main effect of the type and severity of child internalizing and externalizing problems on parental stress, whereby parents of children with more problems experienced the highest parental stress levels. We found no significant interaction effect between time and children’s internalizing and externalizing problems on parental stress. Conclusion: Parental stress remains high, even months after the pandemic. Further research is needed to understand which elements during and after the pandemic were related to the increase in parental stress and which interventions are needed to reduce parental stress to aid health care and policy.