This is written by an expert in Perinatal Mental Health, Dr. Andrew Mayers.
Fathers’ mental health: Why does it matter? What have we done?
I have been working with maternal mental health for over 20 years. It has only been the last 10 of those that I started to include fathers. I did that not to take away what we were doing for mothers but to add to it. I feel that fathers’ mental health matters because if we help the dad, we help the mum (and vice versa). If we help them both, we help their children.
My work with fathers’ mental health has focused on three areas:
What information and support do fathers need to enable him to help his wife or partner should she experience poor mental health during pregnancy and the first two years after their child is born (the perinatal period)?
In many cases, when a father (or father-to-be) sees his partner struggle with poor mental health, it might be the first time he has encountered anyone experiencing these problems. He may not know how to help her or where to seek support from health professionals. Our research certainly confirmed this, which we then used to campaign to get fathers better information and support.
2. What information and support do fathers need should he experience his own poor mental health in the perinatal period? This might be a result of his partner’s poor mental health or where that has developed independently. We know that about 10% of fathers can experience depression symptoms in this period.
We also know that men struggle to seek support for health matters, let alone mental health, due to stigma and stereotyping. It is often seen as weak to talk about emotions. This is even more so in the perinatal period, where the perception is often that fathers need to be the rock at this time. And yet, by not seeking (and getting) help for their mental health, fathers are potentially making the situation worse for themselves and their families.
Our research confirmed that many fathers did not know how much the perinatal period could impact their mental health and that it is OK for them to speak up and seek help. It also showed that, even when fathers did recognise that something was wrong, they did not know where to seek help. For fathers who did want help, few were unable to find services to support them. That research also had an influence on driving changes in NHS services for fathers.
3. What information and support do fathers need should he witness a traumatic birth, perhaps where the wellbeing of his partner and/or child suddenly become at risk.
It wasn’t that long ago that very few fathers were present at the birth of their child. These days, almost all are. Sometimes, the birth may not go to plan. In some cases, the situation can become very serious. Our research showed that fathers are watching this unfold, often helplessly. Following the event, very few fathers get any information about what just happened and receive very little guidance on the potential physical or emotional impact of that trauma on his partner (or how to help her). They also reported being told nothing about how this may affect their own mental health. Without that information and support, both partners are at risk of developing post-traumatic stress disorder (PTSD).
Our research and campaigning have influenced changes in support services and have been used to inform a Parliamentary Public Inquiry.
In 2018, NHS England contacted me, along with other academics and clinicians across the country, asking what the NHS could do to support fathers in the perinatal period more effectively. Based on the evidence that we provided, it was announced that fathers would be screened for their mental health. This was the first of any service like it in the UK. The commencement of those services was curtailed by the COVID pandemic but, since then, many NHS and community support services have begun.
Earlier this year, two British MPs (Theo Clarke and Rosie Duffield) announced that they were launching a Public Inquiry into birth trauma (based on their own personal experiences). They wanted to gather as much evidence as possible to influence the Government about overhauling services and support for mothers and fathers. I was invited to give evidence in Parliament about what more needs to be done for fathers at this time. The final report was published in May 2024, recommending many changes to services and support, including some provisions for fathers.
While we have much to celebrate about the impact of research and campaigning, there is still much to do. It’s great that fathers are being screened for their mental health and signposted to services, but officially, this is only when the mother has been referred to perinatal mental health services. That’s all very well, but not all mothers are referred (or accepted) into those services; fathers in that situation are overlooked. We also know that fathers can develop poor perinatal mental health independently of their partners, so they are missed, too. We need to address that so we can support more fathers.
The birth trauma Public Inquiry was very welcome, and the recommendations are a great start. But there’s much more that needs to be done. One of the biggest problems for fathers is that they usually return to work sooner than their partners. Once they return to work, health professionals will not likely pick them up so easily. It can take several months for PTSD symptoms to emerge. I would like to see more opportunities in the workplace to identify at-risk parents. HR and employee wellbeing teams need to be aware of when parents might be at risk. If employers do not have the resources to support those parents, they need to provide signposts to services that can help.
Above all, we need a whole-family approach to perinatal mental health.
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