Abstract
The number of children with disability is increasing gradually in Japan. Previous researches in other countries have reported that parents as caregivers (CGs) of children with disability have mental health problems, but the actual situation has not been examined nationwide in Japan so far. The aim of this study was to evaluate the association between mental health of CGs who had children with disability and characteristics of children, CGs, and household based on the nation-wide survey. This study utilized data from 2010 Comprehensive Survey of the Living Conditions, and defined children with disability aged 6 to 17. Individual data of children and CGs were linked, and 549 pairs of them were extracted. The Japanese version of Kessler 6 (K6) was used to assess mental health status of caregiver, scored 5 and over represented to general psychological distress. Logistic regression was used to evaluate the associations of interest. The almost half (44.4%) of CGs had psychological distress (k6 score; 5 +) in nationwide, and 8.9% of CGs might have serious mental illness (K6 score; 13+). After adjusting covariates of child, CG, and household factors, CG having a current symptom (OR, 95% CI: 3.26, 1.97–5.39), CG's activity restriction (OR, 95% CI: 2.95, 1.38–6.32), low social support (OR, 95%CI: 9.31, 1.85–46.8), three generation family (OR, 95% CI: 0.49, 0.26–0.92), and lower 25% tile group of monthly household expenditure (OR, 95% CI:1.92, 1.05–3.54), were significantly associated with psychological distress of CGs. This study encourages health care providers to pay more attentions toward parent's mental health, especially for in case of having low social support, and lower income family. Further research should examine the detailed information of child's disease and disability, medical service use, and quality and quantity of social support in nationwide to straighten the system for supporting services of both children with disabilities and their CGs.
Highlights
The number of children with disabilities is gradually increasing in Japan
Previous research reported that higher age of mothers at birth was related to increase of child with intellectual disability [7], and higher age of fathers at birth was associated with an elevated risk of high-functioning autistic-spectrum disorder [8]
This study aimed to examine the mental health of parents of children with disabilities based on nationally representative data in Japan using Kessler 6 (K6) which has been widely implemented in many countries [29] to assess psychological distress
Summary
The number of children with disabilities is gradually increasing in Japan. In 2011, there were 225,000 children with physical disability who received “Physical Disability Certificate (Shintai Syougaisya Tecyou)” or intellectual disabilities who received “Mental Disability Certificate (Ryouiku Tecyou)” living at home in Japan, accounting for 1.1% of the total population of persons under 18 years of age [1, 2]. Average maternal and paternal age of having a first child have become later gradually in Japan: 30.6 years old for mothers and 32.6 years old for fathers in 2014 [6]. Among household with children less than six years old, paternal involvement for housekeeping or child rearing is scarce compared to mothers: only 12 minutes per week for housekeeping and 39 minutes per week for child rearing, comparing to mothers who spent 3.6 hours for housekeeping and 3.4 hours for child rearing on average [19] In these situations, mothers sometimes undertake responsibility for caregiving to a child with disability in fewer supports from family members
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