Evaluating the effects of maternity, paternity and parental leave policy changes on parental mental health using quasi-experimental methods

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Background: Common mental illness is a leading contributor to the global burden of disease. Policymakers are also interested in maximising mental wellbeing. Transition to parenthood may be an important time for future mental health and wellbeing. Social policies supporting paid maternity, paternity or parental leave may affect the mental health of parents in the short and long term through effects on income and material wellbeing, engagement with the labour market, and the participation of both parents in childcare. Most high-income countries have adopted policies for paid parental leave with goals of improving economic or health outcomes. However, few studies have examined the causal effects of different leave policies on maternal and paternal mental health and wellbeing. None have done so in the UK, which has an unusually short period of entitlement to high-rate maternity pay. Aims and objectives: This project aims to address shortcomings in the existing evidence base using quasi-experimental methods. Taking an inter-disciplinary approach, it will build the quantitative evidence base by evaluating the mental health impacts for parents of a series of different parental leave policy changes in the UK. They are:1) Expansion of paid maternity leave to a near-universal entitlement in 19942) Lengthening duration of low-paid maternity leave in 20073) Introduction of entitlements to transfer parental leave from mothers to fathers in 2011 and 2015 It will examine the effects of these policy changes on mental health and wellbeing scores for mothers and fathers at different time points and will also compare effects between those who are single parents and those who have a partner. Methods: The project will use quasi-experimental methods to analyse data from the UK Household Longitudinal Study, a survey which interviewed residents of a representative sample of 40,000 UK households from 2009 onwards. Subject to feasibility and validity checks, the two maternity leave case studies will use regression discontinuity designs. They will compare long-term outcomes for people who had different entitlements to maternity leave and pay but were otherwise similar at the time their children were born. The parental leave case study will use a two-stage instrumental variable approach. It will examine whether and how much the new policy changed the time new fathers took away from work, then the subsequent effect of any change on mental health and wellbeing outcomes for both parents among those who took more time. Alternative quasi-experimental methods will be identified if checks indicate that the planned approaches are not feasible. Skills: the project will enhance quantitative skills and interdisciplinary working through the application of econometric methods to research questions from social epidemiology. It will use a large data set to produce quantitative evaluations of complex interventions by treating policy changes as natural experiments. Strategic alignment: the project is focused on objectives 5.1 and 5.2 of the MRC Strategic Plan. It targets mental health, wellbeing, prevention of disease and health inequity between genders by examining the impact of social policy as one of the wider determinants of health.