Adult mental health and child maltreatment: An ecological study across rural-urban and economic continua with implications for post-pandemic human services

This ecological, county-level, cross-sectional study examines relationships between the mental health of adults (IV) and child maltreatment report rates (DV), as they vary by socioeconomic distress and rurality (n = 3015 counties), using the most recent available data from several linked sources. In a two-way model, maltreatment reports increased 20.1% for each additional half day of poor mental health in metro counties, 11.7% in nonmetro counties, and 13% in rural counties. Our zero-inflated negative binomial model, moderated by rurality and economic distress, showed a significant relationship between the number of poor mental health days and increased child maltreatment report rates in counties (chi(2) = 145.52, p < 0.0001). Investment in prevention and treatment of adult mental health concerns is imperative, especially in light of the increase in mental health problems caused by the coronavirus disease 2019 pandemic and increased tension within national political debate. Our results indicate successful support of adult mental health will prevent child maltreatment and reduce the cyclical financial burden of child maltreatment and mental health concerns.