Prevalence of Psychiatric Disorders Among U. S. Fathers

Purpose: Empirical evidence demonstrates that fathers, including those who experience psychiatric illnesses, are involved in their children's lives1. Understanding the extent of psychiatric illness among US fathers is important as empirical evidence has demonstrated that disorders among this population are associated with impaired parenting practices2-5, such as level of father-child conflict 3, and the likelihood of engaging in parent-child interactions postpartum 2. Difference in prevalence rates for particular psychiatric disorders have been reported between fathers and nonfathers6, and researchers have speculated that the national prevalence among this population is substantial7. However, available national data on prevalence rates, correlates of disorders, and service use among US fathers is scant. This study presents for the first time nationally representative data on the prevalence and correlates of psychiatric disorders among African American, Caribbean Black, and White fathers in the United States.

Method: National estimates of the lifetime and 12-month prevalence rates of psychiatric disorders, correlates of psychiatric disorders, onset before parenthood, and service use are reported on African American (n=1254), Caribbean Black (n=633), and White (n= 1228) fathers using data from the National Institute of Mental Health Collaborative Psychiatric Epidemiology Surveys (National Survey of American Life [NSAL] and National Comorbidity Survey-Replication [NCS-R]). Psychiatric diagnoses were assessed using a fully structured diagnostic interview (DSM-IV/WMH-CIDI). Descriptive and logistic regression analyses were performed.

Results: Nearly 40% of US fathers reported at least one of 19 measured lifetime psychiatric disorders and 15% reported having at least one disorder in the last 12-months. Significant racial differences exist in the prevalence of psychiatric disorders among U. S. fathers with African American and White fathers reporting estimates of 51% and 39% respectively (p<.001), in the prevalence of lifetime disorders. Five out of the 19 measured disorders (PTSD, bi-polar, alcohol, drug and alcohol dependence) had onset before the males became fathers. Caribbean Blacks born in the U. S. reported a significantly higher prevalence rate for psychiatric disorders than those that were foreign born. There were racial and ethnic differences in the type of disorder most common for both lifetime and 12-month prevalence rates. The risk for psychiatric disorders was twice as high for divorced fathers, compared to married or cohabitating fathers. Sociodemographic variables did not differentiate risk for all fathers, except for unemployment among African American fathers (O.R. = 2.0) and having less than a high school education (O.R. = 4.1).

Implications: The prevalence of psychiatric disorders among fathers is more common than previously recognized with every two out of five fathers having a psychiatric disorder. Furthermore, the prevalence of psychiatric morbidity among US fathers varies by race, ethnicity, and nativity, with ethnic minorities being of higher risk, particularly if they are single and unemployed. These results argue for the importance of more research on help-seeking behavior among fathers and the impact of their psychiatric disorders on parenting. The findings suggest that the causes and consequences of psychiatric disorders among fathers should be the focus of research attention and social workers should inquire about the mental health of these men.