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Item Family Change and Child Maintenance Effect on Men’s Mental Health Outcomes in South Africa(University of the Witwatersrand, Johannesburg, 2023-10) Muchemwa, Marifa; Odimegwu, CliffordBackground: Mental health problems are increasing among men in South Africa, yet they remain inadequately studied, particularly within the context of observed family change in the country. National studies have identified the changes taking place in the family system such as increasing rates of divorce, cohabiting, non-marital childbearing, living alone, and delays in family formation. This has resulted in most children growing up in single-parent families, giving rise to child maintenance issues. The changing family situations together with complexities surrounding child maintenance may be pertinent to men’s mental health outcomes, hence the need to examine the nexus. This is important considering that men’s mental health has not been examined in the context of family change and child maintenance in the country. A lack of investigation in this area raises the following question: Do family change and child maintenance complexities contribute to men’s mental health outcomes? Methodology: An explanatory sequential mixed method was conducted to examine family change and child maintenance effects on men’s mental health outcomes in South Africa. The two mental health outcomes which were examined are depressive symptoms and Psychiatric or psychological disorders. The quantitative part of the research used longitudinal secondary data from the National Income Dynamics Study (NIDS) Waves 1-5 (2008-2017) with a sample size of 30 381 men aged 18 and older. The family change examined included a man’s transition from another marital status to being married, living with a partner, divorced, and multiple changes. It also encompassed men who transitioned from living with others to living alone. To analyse the data, the multilevel mixed-effects logistic regression and the General Estimating Equations (GEE) models were used. In the qualitative research, 30 men residing in Johannesburg were recruited using purposive and snowballing sampling methods. The men were interviewed using semi-structured in-depth interviews. The data were analysed using thematic analysis. Key Findings: Quantitative findings indicate that men who changed to cohabiting had an increased likelihood of experiencing depressive symptoms compared to those who did not go through a family change. Men who changed to live alone had an increased likelihood of experiencing both mental health outcomes compared to men who remained living with others. Men who became married had a lower likelihood of experiencing depressive symptoms than men who did not go through any family change. The qualitative findings show that it is not only family change, but its consequences linked to child maintenance complexities that is more stressful affecting men’s mental well-being. The consequences include being denied access and custody of the children. Trying to adjust to living away from their children and being excluded from the children’s lives by their ex-partners left men distressed. Quantitative findings show that men who paid child maintenance were less likely to experience psychiatric or psychological disorders than men who were not paying. However, from the qualitative findings, men who were paying child maintenance complained of how their partners gave them limited access to the children and only sought money from them making it appear as if it is the only role they can do for their children. Yet they wanted to be part of their children’s lives. Some of the men cried as they explained how being excluded from the lives of their children affected their health. Conclusions: The findings indicate that changing to live alone is a risk factor for both mental health outcomes. Men who changed to live with a partner (cohabiting) had an increased risk of experiencing depressive symptoms. Those who transitioned to be married across the five waves had a reduced likelihood of experiencing depressive symptoms. Child maintenance complexities that men encounter also affect their mental health. The complexities include undermining the fatherhood role through the exclusion in decision-making, denial of access to the children, and child custody. Policy recommendations: The findings imply that the changing nature of the family in South Africa characterised by increasing cohabitation and living alone affects men’s mental health. Men living alone and cohabiting require mental health support. Counselling should be done simultaneously with interventions that help men who are denied access to their children. Community programs that address mental health needs of men undergoing family change should be done. Including educational campaigns that raise awareness about mental health implications of family change and the importance of seeking help. Child access denial should be addressed, existing laws should ensure that both parents have equal access to the children. Crying in men should be normalized through public awareness campaigns that challenge traditional notions of masculinity. Interventions to assist men experiencing challenges to have access to their children should be carried out simultaneously with counselling as the findings highlight that men live with the pain of being denied access and custody of their children. Frontiers for Further Research: The findings showed that men were weak and powerless on matters to do with child access and custody for their children from previous relationships. Studies should be conducted which explore how the hegemonic masculinities are affected in the context of child maintenance and investigate how men feel when they experience challenges as fathers documenting their experiences regarding the various health problems, they have developed. There is a need to study gender differences in the context of family change and mental health in South Africa considering an increase in mental health problems and the changing nature of the family. The study findings show that depressive symptoms are concentrated more among young men than the elderly. Further research can be done that focus on male adolescents’ mental health.