| Sumario: | Objectives. To examine the associations between paternal leave status and mental health symptoms in a large population-representative study of fathers after the birth of a child. Methods. We used data from the 2022–2023 Ohio Fatherhood Survey (OFS) to model the relationship between paid work leave factors and mental health (Patient Health Questionnaire-2 [PHQ-2] and Generalized Anxiety Disorder-2 [GAD-2]) by using weighted descriptive analyses and adjusted logistic regression modeling. Results. Fathers with unpaid leave were more likely to report anxiety symptoms (adjusted odds ratio [AOR] = 1.58; 95% confidence interval [CI] = 1.00, 2.48) compared with fathers with paid leave, while unmet needs were associated with increased depression (AOR = 3.21; 95% CI = 1.92, 5.37) and anxiety (AOR = 3.12; 95% CI = 2.02, 4.83) symptoms. Furthermore, barriers to work leave, including financial barriers (PHQ-2 = 74.6%; GAD-2 = 71.2%) were more prevalent among fathers who reported recent mental health symptoms. Conclusions. Paid paternal leave status and leave barriers are associated with mental health symptoms. Public Health Implications. Equitable paid paternal leave may strengthen mental health, highlighting a public health pathway toward improving father and family well-being. (Am J Public Health. 2026;116(8):1136–1145. https://doi.org/10.2105/AJPH.2026.308554)
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