Household mental distress and child cognitive development in Ghana.

INTRODUCTION: Household mental wellbeing plays an important role in children's cognitive development, yet evidence from developing countries remains limited. This study examines the relationship between household mental distress and children's cognitive development in Ghana. METHODS: We use nationally representative longitudinal data from the Ghana Socioeconomic Panel Survey (2009-2010, 2013-2014, and 2018), comprising 8,755 children aged 5-17 years. Children's cognitive ability is measured using a composite index derived from the Digit Span Forward, Digit Span Backward, and Raven's Progressive Matrices assessments. Household mental distress is measured using the average Kessler Psychological Distress Scale (K10) score of adults in the household. To address potential endogeneity, we employ a leave-one-out community mental distress instrumental variable and supplement the analysis with alternative instrumental-variable specifications, treatment matching, and placebo tests. RESULTS: Across all estimation approaches, children living in mentally distressed households exhibit significantly lower cognitive performance than children in non-distressed households. Estimated effects range from 0.43 to 0.49 standard deviations and are observed among both pre-teens (5-12 years) and adolescents (13-17 years). Analyses using a continuous measure of household mental distress produce similar findings consistent with a dose-response relationship. DISCUSSION: Household mental distress is strongly associated with children's cognitive development in Ghana. Policies aimed at improving children's developmental outcomes may therefore benefit from greater attention to adult mental health within households.