When Parents Can Spare Time: Paid Sick Leave and Adolescent Mental Health

Abstract

Adolescents in the United States face rising rates of depression, anxiety, and suicidality, yet structural barriers such as parental work constraints continue to limit timely access to care. This paper provides new causal evidence that state Paid Sick Leave (PSL) mandates improve adolescent mental health. Using the staggered adoption of PSL mandates across states, we find that PSL laws increase the probability that an adolescent received any mental or behavioral health care in the past year by 2.3 percentage points (a 13.6% increase relative to the baseline mean of 17.1%) and raise parent-reported depression diagnoses by 1.5 percentage points (a 14.1% increase relative to the baseline mean of 10.9%). Complementary evidence from the Youth Risk Behavior Surveillance System shows that PSL mandates reduce self-reported depressive symptoms by 2.2 percentage points (7.2%) and passive suicidal ideation by 1.4 percentage points (8.6%), with no detectable effects on active suicidal ideation. Mechanism analyses suggest that these improvements operate primarily through enhanced parental time flexibility and increased engagement with the mental health care system. These findings highlight that labor protections enabling parental time flexibility can serve as an upstream intervention for adolescent mental health.

Keywords: Paid Sick Leave, Adolescent Mental Health, Health Care Utilization, Parental Time