Single mothers experience high rates of psychological distress. The safety net can help.

About one-third of all mothers in the U.S. today are unmarried. On average, single mothers have lower levels of wealth, are more vulnerable to economic shocks, and have more caregiving responsibilities. They are also more likely to experience mental health challenges. Mental health is a key factor in maternal well-being and can have wider impacts on families. For example, poor maternal mental health is associated with worse academic and psychological outcomes for children. Improving maternal mental health is one pillar of strengthening family well-being.

Single mothers experience higher levels of psychological distress

Building on recent work from Lucie Schmidt, Lara Shore-Sheppard, and Tara Watson, we use data from the 2016-2018 National Health Interview Survey (NHIS) to examine psychological distress among single mothers, defined as those who are not married, regardless of partner status. The Kessler-6 (K6) indicator uses six specific questions about feelings of sadness, hopelessness, nervousness, and more within the last thirty days. Moderate psychological distress is defined as a Kessler score between 5 and 12 and severe psychological distress is a Kessler score over 12. The validity of the K6 indicator has been studied in clinical settings and validated as a measure of mental health status. Rates of psychological distress differ by mother’s marital status. As shown in Figure 1, 32% of single mothers experience moderate or severe psychological distress, compared to 19% of married mothers. Single mothers are also more than three times as likely to experience severe psychological distress than married mothers: Seven percent of single mothers reported signs of severe distress compared to two percent of married mothers.

Part of the mental health gap between single and married mothers is likely related to the psychological burden of living in poverty. Single mothers are more likely to live in poverty: In the 2016-2018 sample, 38% of single mothers lived below the poverty threshold compared with 9% of married mothers. Figure 2 shows that, among both married mothers and among single mothers, those experiencing poverty are more likely to face mental health challenges. It is also the case that single mothers living in poverty tend to experience more distress than married mothers in poverty, and single mothers of each major race/ethnicity group have higher rates of distress than their married counterparts (see Figure 3).

Policy makes a difference

The high rates of psychological distress among single mothers are concerning, but there are policy levers that can help. Research published last year by Lucie Schmidt, Lara Shore-Sheppard and Tara Watson examines the possibility that the safety net can improve mental health. The paper assesses eligibility and benefit rules for non-immigrant, non-disabled single mothers across states from 1997-2016, focusing on the Earned Income Tax Credit (EITC), the refundable portion of the Child Tax Credit (CTC), Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Medicaid. The research takes into account eligibility interactions across programs because families often participate in multiple programs at the same time. By applying state rules to a common sample of single mothers, the authors generate an index of safety net generosity across states and over time for single mother families with different characteristics. They then use the index to evaluate the effect of a more generous safety net on mental health. Figure 4 shows the impact of an extra $1,000 in benefit generosity for single-mother families. With more generosity, severe distress is reduced by a third of a percentage point, about an 8% reduction. Overall psychological distress decreases by 0.6 percentage points, or 2.5%. To put the effects in context, the annual difference in total cash and food benefit generosity between the 10th percentile state, Georgia, and the 90th percentile state, New York, was $1,902 at the end of the study period in 2016. This difference in benefit generosity is enough to close a little over a tenth of the gap in severe psychological distress between married and single mothers, according to the results of the study.

Which policy prescriptions can better protect single mothers’ mental health?

Single mothers face economic challenges, but research shows that safety net program generosity improves mothers’ mental health and creates positive spillover effects for their children. An expanded Child Tax Credit, such as the recent bipartisan proposal, is one promising possibility. Another strategy is to improve access of eligible families to existing safety net programs by addressing barriers to participation such as lack of information and stigma. Efforts to increase the generosity of and access to the safety net should be complemented with improved access to mental health care. Investing in solutions such as Certified Community Behavioral Health Centers (CCBHCs) could increase access. So could increasing Medicaid reimbursement rates to providers for mental health services, which are lower than Medicare reimbursement rates in most states.

Rates of psychological distress remain high for single mothers due to economic insecurity and other challenges. Boosting access to mental health care and safety net supports would likely benefit these mothers and their families.