COVID-19 and mental health in Australia - a scoping review.

BACKGROUND: The COVID-19 outbreak has spread to almost every country around the world and caused more than 3 million deaths. The pandemic has triggered enormous disruption in people's daily lives with profound impacts globally. This has also been the case in Australia, despite the country's comparative low mortality and physical morbidity due to the virus. This scoping review aims to provide a broad summary of the research activity focused on mental health during the first 10 months of the pandemic in Australia. RESULTS: A search of the Australian literature was conducted between August-November 2020 to capture published scientific papers, online reports and pre-prints, as well as gaps in research activities. The search identified 228 unique records in total. Twelve general population and 30 subpopulation group studies were included in the review. CONCLUSIONS: Few studies were able to confidently report changes in mental health driven by the COVID-19 context (at the population or sub-group level) due to a lack of pre-COVID comparative data and non-representative sampling. Never-the-less, in aggregate, the findings show an increase in poor mental health over the early period of 2020. Results suggest that young people, those with pre-existing mental health conditions, and the financially disadvantaged, experienced greater declines in mental health. The need for rapid research appears to have left some groups under-researched (e.g. Culturally and Linguistically Diverse populations and Indigenous peoples were not studied), and some research methods under-employed (e.g. there was a lack of qualitative and mixed-methods studies). There is a need for further reviews as the follow-up results of longitudinal studies emerge and understandings of the impact of the pandemic are refined.

Bushfire Smoke in Our Eyes: Community Perceptions and Responses to an Intense Smoke Event in Canberra, Australia.

The 2019-20 bushfires that raged in eastern Australia were an overwhelming natural disaster leading to lives lost or upended, and communities destroyed. For almost a month, Canberra, Australia's capital city in the Australian Capital Territory (ACT), was obscured by smoke from fires which threatened the outer suburbs. While smoke itself is experientially different from many natural disasters, it nevertheless poses a significant public health threat. As the impact of extended bushfire smoke in an urban setting is relatively unexplored we aimed to capture the individual and community-level experiences of the event and their importance for community and social functioning. We responded rapidly by conducting semi-structured interviews with a range of Canberra residents who, due to their personal or social circumstances, were potentially vulnerable to the effects of the smoke. Three major themes emerging from the narratives depicted disruption to daily life, physical and psychological effects, and shifting social connectedness. This study highlighted the ambiguous yet impactful nature of a bushfire smoke event, and identified four simple key messages that may be critically relevant to policy making in preparation for similar smoke events in the future.

How does working nonstandard hours impact psychological resources important for parental functioning? Evidence from an Australian longitudinal cohort study.

This study investigates the link between nonstandard schedules and three psychological resources salient to working parents' parental functioning (psychological distress, work-family conflict and relationship quality). Data from fathers and mothers are analysed separately, using a nationally representative sample of dual-earner parents (6190 observations from 1915 couples) drawn from the Longitudinal Study of Australian Children (LSAC). The LSAC data was collected between 2008 and 2018 (with data collected every two years). Hybrid analysis models were conducted to identify within-person changes in these psychological resources in association with moving in and out of nonstandard work schedules, as well as between-person differences between parents working standard hours and nonstandard hours. The results indicate that the connections between working nonstandard schedules and the psychological resources were patterned differently across genders. No significant differences in psychological distress were found between those working nonstandard schedules and those working standard schedules for either fathers or mothers. Fathers working nonstandard schedules had higher work-family conflict compared to fathers working standard schedules, while no such effect found for mothers. This effect for fathers was largely explained by other characteristics related to working a nonstandard schedule, rather than the schedule itself. For fathers (but not mothers), working nonstandard schedules was significantly, and potentially causally, associated with lower relationship quality (i.e. within-person effects were found). Additional supplementary analyses found the connections between work schedules and psychological resources varied somewhat across different types of schedules (i.e. evening/night shift, rotating shift and irregular shift). As one of the first nationally representative longitudinal studies to explore changes in work schedules in association with changes in parents' psychosocial resources, the impacts for fathers (particularly relationship quality) are an important line for future enquiry.

Australian parents' work-family conflict: accumulated effects on children's family environment and mental health.

PURPOSE: Many parents struggle to balance their work and family responsibilities. Yet, little research in the field of social psychiatry has explored the emergence of work-family conflict (WFC) as an important social determinant of mental health, particularly for children. The current study used longitudinal Australian population-based data to investigate the impact of parents' accumulated experiences of work-family conflict on children's mental health. Levels of parent psychological distress, marital satisfaction and parenting irritability were examined as potential explanatory factors within the family environment. METHODS: The study used five waves of data from the Australian Longitudinal Study of Australian Children (LSAC), a representative community sample of Australian children and their parents. Analyses were restricted to coupled, employed mothers (1903) and fathers (1584) who reported their WFC levels in all five waves. Structural Equation Modelling (SEM) was used to examine the association between accumulated experiences of work-family conflict across all time-points (AWFC) and children's mental health at wave 5. Family environment factors were assessed as possible explanatory mediators. RESULTS: There was a significant association between AWFC and children's mental health at wave 5. Parent psychological distress, marital satisfaction and parenting irritability were all found to significantly explain this association (accounting for 66% of the total effect). CONCLUSIONS: Children whose parents have ongoing or accumulated difficulties managing their work and family responsibilities are more likely to have poorer mental health. This has important implications for family-friendly work arrangements and demonstrates the need to further understand the intergenerational impacts of parents' jobs on their children's psychological wellbeing.

Workplace Bullying and Suicidal Ideation: Findings from an Australian Longitudinal Cohort Study of Mid-Aged Workers.

Workplace bullying adversely affects mental health, yet little is known about the outcomes for suicidal ideation. The current study used Australian population-based data to investigate the association between workplace bullying and suicidal ideation. The sample included 1488 employed participants aged 52-58 from wave 4 of the Personality and Total Health (PATH) Through Life Study. Workplace bullying was measured in two ways: (a) a single item asked about experiences of bullying 'currently', 'previously in the current workplace' and 'in a past workplace', and (b) 15 items asked about bullying behaviours experienced in the past 6 months. Suicidal ideation was measured using items from the Psychiatric Symptom Frequency Scale (PSF) and the Patient Health Questionnaire-9 (PHQ-9). Psychosocial job quality, both current and prior, was adjusted for. Current and past experiences of workplace bullying were associated with increased risk of suicidal ideation. Current experiences were no longer associated after adjusting for concurrent indicators of psychosocial job stress, although a tendency for increased ideation remained. Reported prior experience of workplace bullying in a past workplace remained associated with higher odds of suicidal ideation after adjusting for prior psychosocial job stressors and excluding individuals with prior suicidal ideation. Being bullied at work is associated with increased risk of suicidal thoughts, although this occurs within the broader influence of other psychologically stressful employment conditions.

Recruiting fathers for parenting research using online advertising campaigns: Evidence from an Australian study.

BACKGROUND: Fathers are underrepresented in parenting and child health research. Given there is a strong link between fathers' parenting behaviour and children's well-being, there is a need to find ways to engage fathers more consistently. The current short report provides information and learnings about recruiting fathers online using social media. Results are drawn from an Australian study that aimed to recruit roughly equal numbers of mothers and fathers to participate in a survey about employment, parenting, and health, using online advertising. METHODS: First, a series of five Facebook advertising campaigns were run, aimed at "parents" generally (i.e., gender-neutral). A lack of recruited fathers prompted a second series of six Facebook campaigns aimed solely at fathers. All campaigns targeted employed adult parents of children (≤18 years) in Australia using Facebook's "Adverts Manager." RESULTS: The 11 campaigns recruited a total of 1,468 fathers. The vast majority of these fathers were recruited using the advertisements specifically aimed at fathers (n = 1,441). Gender-neutral campaigns inviting and selecting "parents" to participate in the study overwhelmingly yielded samples of mothers. Similarly, advertisements inviting both "mums and dads" resulted in very low recruitment of fathers. CONCLUSIONS: The extremely low numbers of fathers recruited using the gender-neutral "parent-focused" campaigns was unexpected. Potential reasons for this include low engagement with gender-neutral parenting terms, and/or that mothers were disproportionally exposed to the Facebook advertisements. These learnings suggest that father-focused recruitment is required to target and engage fathers in parenting research and services.

Shift work and mental health: a systematic review and meta-analysis.

BACKGROUND: Shift work is common. However, research findings are mixed regarding the impact of shift work on mental health. This systematic review sought to provide a comprehensive summary of existing research examining the association between different types of shift work and mental health. The review included large-scale, non-occupation-specific research. METHODS: Four electronic databases PubMed, PsycINFO, Web of Science and SCOPUS were searched to identify studies that reported on the statistical association between shift work and mental health and that used population-based samples. Two reviewers extracted information about study characteristics and data on the association between shift work and mental health. A meta-analysis was performed for longitudinal studies adopting a 'broad binary' measure of shift work. RESULTS: Thirty-three studies were included in the final review-10 cross-sectional studies, 22 longitudinal studies, and 1 study that included both. Findings were grouped based on whether the measure of shift work focussed on: (1) night/evening work, (2) weekend work, (3) irregular/unpredictable work schedule, or (4) a broad binary measure. There was a reasonable level of evidence that overall, when a broad binary measure was adopted, shift work was associated with poorer mental health-this finding was supported by the meta-analysis results. There was also some evidence that irregular/unpredictable work was associated with poorer mental health. There was less evidence for night/evening and minimal evidence for weekend work. Inconsistencies in study methodology, limited contrasting and combining the results. CONCLUSIONS: The association between shift work and mental health is different across types of shift work. The evidence is strongest for a broad binary, general measure of shift work and for irregular or unpredictable shift work. There is a need for continued research that adopts consistent and clear measures of shift work.

Using Paid and Free Facebook Methods to Recruit Australian Parents to an Online Survey: An Evaluation.

BACKGROUND: The prevalence of social media makes it a potential alternative to traditional offline methods of recruiting and engaging participants in health research. Despite burgeoning use and interest, few studies have rigorously evaluated its effectiveness and feasibility in terms of recruitment rates and costs, sample representativeness, and retention. OBJECTIVE: This study aimed to determine the feasibility of using Facebook to recruit employed Australian parents to an online survey about managing work and family demands, specifically to examine (1) recruitment rates and costs; (2) sample representativeness, compared with a population-based cohort of parents; and (3) retention, including demographic and health characteristics of parents who returned to complete a follow-up survey 6 weeks later. METHODS: Recruitment was conducted using 20 paid Facebook advertising campaigns, supplemented with free advertising approaches such as posts on relevant Facebook pages and requests for professional networks to circulate the survey link via Facebook. Recruitment rates and costs were evaluated using the Checklist for Reporting Results of Internet E-Surveys, including view rate, participation rate, completion rate, cost per consent, and cost per completer. Sample representativeness was evaluated by comparing demographic and outcome variables with a comparable sample from the Longitudinal Study of Australian Children including educational attainment, marital status, country of birth, neighborhood disadvantage, work-family conflict, and psychological distress. Retention was evaluated by comparing the number and demographic characteristics of participants at recruitment and at 6-week follow-up. RESULTS: Recruitment strategies together resulted in 6653 clicks on the survey link, from which 5378 parents consented to participate and 4665 (86.74%) completed the survey. Of those who completed the survey, 85.94% (4009/4665) agreed to be recontacted, with 57.79% (2317/4009) completing the follow-up survey (ie, 43.08% [2317/5378] of parents who consented to the initial survey). Paid Facebook advertising recruited nearly 75% of the sample at Aus $2.32 per completed survey (Aus $7969 spent, 3440 surveys completed). Compared with a population-based sample, participants at baseline were more likely to be university educated (P<.001), experience greater work-family conflict (P<.001) and psychological distress (P<.001), and were less likely to be born outside Australia (P<.001) or live in a disadvantaged neighborhood (P<.001). CONCLUSIONS: Facebook provided a feasible, rapid method to recruit a large national sample of parents for health research. However, some sample biases were observed and should be considered when recruiting participants via Facebook. Retention of participants at 6- to 8-week follow-up was less than half the initial sample; this may reflect limited ongoing participant engagement for those recruited through social media, compared with face-to-face.

Comorbid anxiety and depression: a community-based study examining symptomology and correlates during the postpartum period.

Background: Despite indications that anxiety and depression co-occur frequently within the postpartum period, studies identifying the correlates associated with this comorbidity are rare. Objective: This study assessed variation in social and maternal circumstances, based on comorbid anxiety and depression symptomology. Methods: A large community-based sample of 1070 Australian postpartum women completed the Living with a Young Baby online survey. Mothers were categorised into groups: (a) comorbid anxiety and depression symptomology, (b) anxiety only, (c) depression only, or (d) neither depression nor anxiety. Multinomial Logistic Regression (MLR) investigated variation in correlates between the groups. Results: Comorbid anxiety and depression symptomology was common (13.4%), and was associated with greater symptom severity. Women in the 'comorbid' group more often experienced financial hardship, cessation of breastfeeding, infants with difficult temperaments, inadequate social support or help, and stressful adverse life events in comparison to mothers in the 'neither symptomology' group. They were also more likely to have infants with difficult temperaments compared to the depression only group, and to receive inadequate help and support compared to the anxiety only group. Conclusions: Comorbid anxiety and depression symptomology is common postpartum and is associated with considerable adversity across a wide range of demographic, economic and social correlates. Abbreviations: EPDS: Edinburgh Postnatal Depression Scale; STAI: State-Trait Anxiety Inventory; MLR: Multiple Logistic Regression; LYBS: Living with a Young Baby Survey; LSAC: Longitudinal Study of Australian Children; STSI: Short Temperament Scale for Infants; ANOVA: Analysis of Variance; M: Mean; SD: Standard Deviation; CI: Confidence Interval; OR: Odds Ratio.

A longitudinal test of the predictions of the interpersonal-psychological theory of suicidal behaviour for passive and active suicidal ideation in a large community-based cohort.

BACKGROUND: The Interpersonal-Psychological Theory of Suicide (IPTS) aims to elucidate the key antecedents of suicide deaths. Limited research has tested the IPTS in a community setting, and very little longitudinal research has been conducted. The current study longitudinally tested the predictions of the IPTS for suicidal ideation in a large population-based sample. METHODS: The PATH through Life study assesses three age cohorts (20's, 40's, 60's) every four years. Two interpersonal factors were estimated at the third wave of assessment: thwarted belongingness (TB) and perceived burdensomeness (PB). The roles of these factors in suicide ideation (active and passive) four years later were estimated using logistic regression models (n = 4545). RESULTS: A one SD increase in TB was associated with increased odds of 37% for passive ideation and 24% for active ideation. For PB, odds were increased 2.5-fold for passive ideation and 2.4-fold for active ideation. A significant negative PB × TB interaction was found for passive but not active ideation. Effects were not consistent by age group or gender. LIMITATIONS: Proxy measures were used to assess the constructs. The extended timeframe and low prevalence of suicidal ideation limited power to find effects within subgroups. CONCLUSIONS: Although TB and PB were individually associated with suicidal thoughts, little evidence was found for the key predictions of the IPTS longitudinally. Further investigation of the dynamic interplay between interpersonal factors over time is needed.

Early Onset of Distress Disorders and High-School Dropout: Prospective Evidence From a National Cohort of Australian Adolescents.

Prior research examining whether depression and anxiety lead to high-school dropout has been limited by a reliance on retrospective reports, the assessment of mental health at a single point in time (often remote from the time of high-school exit), and the omission of important measures of the social and familial environment. The present study addressed these limitations by analyzing 8 waves of longitudinal data from a cohort of Australian adolescents (n = 1,057) in the Household, Income and Labor Dynamics in Australia (HILDA) Survey (2001-2008). Respondents were followed from the age of 15 years through completion of or exit from high school. Discrete-time survival analysis was used to assess whether the early experience of a distress disorder (indicated by scores <50 on the 5-item Mental Health Inventory from the Short Form Health Survey) predicted subsequent high-school dropout, after controlling for household and parental socioeconomic characteristics and for tobacco smoking and alcohol consumption. Adolescents with a prior distress disorder had twice the odds of high-school dropout compared with those without (odds ratio = 1.99, 95% confidence interval: 1.24, 3.17). This association was somewhat attenuated but remained significant in models including tobacco and alcohol consumption (odds ratio = 1.74, 95% confidence interval: 1.74; 1.09, 2.78). These results suggest that improving the mental health of high-school students may promote better educational outcomes.

Parents' transitions into and out of work-family conflict and children's mental health: Longitudinal influence via family functioning.

The demands arising from the combination of work and family roles can generate conflicts (work-family conflicts), which have become recognized as major social determinants of mothers' and fathers' mental health. This raises the question of the potential effects on children. The current study of 2496 Australian families (7652 observations from children aged 4-5 up to 12-13 years) asks whether changes in children's mental health corresponds with changes in mothers' and fathers' work-family conflicts. Using longitudinal random-effect structural equation models, adjusting for prior child mental health, changes in work-family conflict were examined across four adjacent pairs of biennial data waves. Children's mental health deteriorated when their mother or father experienced an increase in work-family conflict, but improved when parents' work-family conflict reduced. Results held for mothers, fathers and couples, and the key pathways appear to be changes in children's relational environments. These results contribute new evidence that conflicts between the work-family interface are powerful social determinants of mental health which have an intergenerational reach.

Online Recruitment: Feasibility, Cost, and Representativeness in a Study of Postpartum Women.

BACKGROUND: Online recruitment is feasible, low-cost, and can provide high-quality epidemiological data. However, little is known about the feasibility of recruiting postpartum women online, or sample representativeness. OBJECTIVE: The current study investigates the feasibility of recruiting a population of postpartum women online for health research and examines sample representativeness. METHODS: Two samples of postpartum women were compared: those recruited online as participants in a brief survey of new mothers (n=1083) and those recruited face-to-face as part of a nationally representative study (n=579). Sociodemographic, general health, and mental health characteristics were compared between the two samples. RESULTS: Obtaining a sample of postpartum women online for health research was highly efficient and low-cost. The online sample over-represented those who were younger (aged 25-29 years), were in a de facto relationship, had higher levels of education, spoke only English at home, and were first-time mothers. Members of the online sample were significantly more likely to have poor self-rated health and poor mental health than the nationally representative sample. Health differences remained after adjusting for sociodemographic differences. CONCLUSIONS: Potential exists for feasible and low-cost e-epidemiological research with postpartum populations; however, researchers should consider the potential influence of sample nonrepresentativeness.

Workplace bullying and the association with suicidal ideation/thoughts and behaviour: a systematic review.

The established links between workplace bullying and poor mental health provide a prima facie reason to expect that workplace bullying increases the risk of suicidal ideation (thoughts) and behaviours. Until now, there has been no systematic summary of the available evidence. This systematic review summarises published studies reporting data on workplace bullying and suicidal ideation, or behaviour. The review sought to ascertain the nature of this association and highlight future research directions. 5 electronic databases were searched. 2 reviewers independently selected the articles for inclusion, and extracted information about study characteristics (sample, recruitment method, assessment and measures) and data reporting the association of workplace bullying with suicidal ideation and behaviour. 12 studies were included in the final review-8 reported estimates of a positive association between workplace bullying and suicidal ideation, and a further 4 provided descriptive information about the prevalence of suicidal ideation in targets of bullying. Only 1 non-representative cross-sectional study examined the association between workplace bullying and suicidal behaviour. The results show an absence of high-quality epidemiological studies (eg, prospective cohort studies, which controlled for workplace characteristics and baseline psychiatric morbidity). While the available literature (predominantly cross-sectional) suggests that there is a positive association between workplace bullying and suicidal ideation, the low quality of studies prevents ruling out alternative explanations. Further longitudinal, population-based research, adjusting for potential covariates (within and outside the workplace), is needed to determine the level of risk that workplace bullying independently contributes to suicidal ideation and behaviour.

Correlates of transient versus persistent psychotic symptoms among dependent methamphetamine users.

This study examined correlates of transient versus persistent psychotic symptoms among people dependent on methamphetamine. A longitudinal prospective cohort study of dependent methamphetamine users who did not meet DSM-IV criteria for lifetime schizophrenia or mania. Four non-contiguous one-month observation periods were used to identify participants who had a) no psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient psychotic symptoms, n=85); and, (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent psychotic symptoms, n=37). Psychotic symptoms were defined as a score of 4 or greater on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content. Relative no psychotic symptoms, both transient and persistent psychotic symptoms were associated with childhood conduct disorder and comorbid anxiety disorders. Earlier onset methamphetamine use and being male were more specifically related to transient psychotic symptoms, while a family history of a primary psychotic disorder and comorbid major depression were specifically related to persistent psychotic symptoms. We conclude that there are overlapping but also distinct clinical correlates of transient versus persistent psychotic symptoms, suggesting potentially heterogeneous etiological pathways underpinning the psychotic phenomena seen amongst people who use methamphetamine.

Why it's important for it to stop: Examining the mental health correlates of bullying and ill-treatment at work in a cohort study.

OBJECTIVE: There is limited Australian information on the prevalence and mental health consequences of bullying and ill-treatment at work. The aims of this study were to use data from an ongoing Australian longitudinal cohort study to (1) compare different measures of workplace bullying, (2) estimate the prevalence of bullying and ill-treatment at work, (3) evaluate whether workplace bullying is distinct from other adverse work characteristics and (4) examine the unique contribution of workplace bullying to common mental disorders in mid-life. METHOD: The sample comprised 1466 participants (52% women) aged 52-58 from wave four of the Personality and Total Health (PATH) through Life study. Workplace bullying was assessed by a single item of self-labelling measure of bullying and a 15-item scale of bullying-related behaviours experienced in the past 6 months. Factor analysis the identified underlying factor structure of the behavioural bullying scale. RESULTS: Current bullying was reported by 7.0% of respondents, while 46.4% of respondents reported that they had been bullied at some point in their working life. Person-related and work-related bullying behaviours were more common than violence and intimidation. The multi-dimensional scale of bullying behaviours had greater concordance with a single item of self-labelled bullying (Area Under the Curve = 0.88) than other adverse work characteristics (all Area Under the Curves < 0.67). Self-labelled bullying and scales reflecting person-related and work-related bullying were independent predictors of depression and/or anxiety. CONCLUSION: This study provides unique information on the prevalence and mental health impacts of workplace bullying and ill-treatment in Australia. Workplace bullying is a relatively common experience, and is associated with increased risk of depression and anxiety. Greater attention to identifying and preventing bullying and ill-treatment in the workplace is warranted.

Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review.

BACKGROUND: Men's experiences of anxiety within the perinatal period can adversely impact themselves, their partner and infant. However, we know little about the prevalence and course of men's anxiety across the perinatal period. The current review is one of the first to systematically review the published literature. METHODS: Five databases (PubMed, PsycINFO, Cochrane, SCOPUS, and Web of Science) were searched to identify relevant papers published prior to April 2015. The literature search identified articles with data for expectant fathers (prenatal period) and/or fathers of an infant aged between 0 and 1 (postnatal period). The following data were extracted: (a) anxiety disorder prevalence (diagnostic clinical interviews), (b) 'high' anxiety symptom prevalence (above thresholds/cut-points on anxiety symptom scales) and (c) mean anxiety levels (anxiety symptom scales). Initially, 537 unique papers were identified. Subsequently, 43 papers met criteria for inclusion in the review. RESULTS: Prevalence rates for 'any' anxiety disorder (as defined by either diagnostic clinical interviews or above cut-points on symptom scales) ranged between 4.1% and 16.0% during the prenatal period and 2.4-18.0% during the postnatal period. The data reviewed suggest the course of anxiety across the perinatal period is fairly stable with potential decreases postpartum. LIMITATIONS: Wide variation in study measurement and methodology makes synthesis of individual findings difficult. Anxiety is highly comorbid with depression, and thus measures of mixed anxiety/depression might better capture the overall burden of mental illness. CONCLUSIONS: Anxiety disorders are common for men during the perinatal period. Both partners should be included in discussions and interventions focused on obstetric care and parent mental health during the perinatal period.

What matters for working fathers? Job characteristics, work-family conflict and enrichment, and fathers' postpartum mental health in an Australian cohort.

One in ten fathers experience mental health difficulties in the first year postpartum. Unsupportive job conditions that exacerbate work-family conflict are a potential risk to fathers' mental health given that most new fathers (95%) combine parenting with paid work. However, few studies have examined work-family conflict and mental health for postpartum fathers specifically. The aim of the present study was to identify the particular work characteristics (e.g., work hours per week, job quality) associated with work-family conflict and enrichment, and fathers' mental health in the postpartum period. Survey data from 3243 fathers of infants (aged 6-12 months) participating in the Longitudinal Study of Australian Children were analysed via path analysis, considering key confounders (age, education, income, maternal employment, maternal mental health and relationship quality). Long and inflexible work hours, night shift, job insecurity, a lack of autonomy and more children in the household were associated with increased work-family conflict, and this was in turn associated with increased distress. Job security, autonomy, and being in a more prestigious occupation were positively associated with work-family enrichment and better mental health. These findings from a nationally representative sample of Australian fathers contribute novel evidence that employment characteristics, via work-family conflict and work-family enrichment, are key determinants of fathers' postnatal mental health, independent from established risk factors. Findings will inform the provision of specific 'family-friendly' conditions protective for fathers during this critical stage in the family life-cycle, with implications for their wellbeing and that of their families.

Depression and anxiety in expectant and new fathers: longitudinal findings in Australian men.

BACKGROUND: Despite growing interest in men's perinatal mental health, we still know little about whether becoming a new father is associated with increases in psychological distress. AIMS: To use prospective longitudinal data to investigate whether becoming a first-time expectant (partner pregnant) and/or new father (child <1 year) is associated with increases in depression and anxiety. METHOD: Men were aged 20-24 years at baseline (n = 1162). Levels of depression and anxiety were measured at four time points over 12 years. Over this time, 88 men were expectant fathers, 108 men were new fathers and 626 men remained non-fathers. RESULTS: Longitudinal mixed models showed no significant increase in depression or anxiety as a function of expectant or new fatherhood, as compared with pre-fatherhood levels. CONCLUSIONS: Our findings suggest that, generally, expectant and new fathers are not at greater risk of depression or anxiety. Future epidemiological research should continue to identify men who are most (and least) at risk to focus resources and assistance most effectively.