Fathers’ mental health: why is it important?

Changes in mothers' mental health during the perinatal period have been well studies, while fathers' mental health during the same often-difficult period has not received as much attention, despite the many ways that fathers' mental health challenges can affect the whole family. In honor of International Fathers Mental Health Day today, the author of two recent papers on fathers' mental health, published in BMC Pregnancy and Childbirth, discusses some of the ways that fathers need mental health support for their own wellbeing and that of their partners and children.

Putting fathers’ mental health into perspective

Becoming a father is an extremely important life event for a man. Fathers can experience new emotions, feelings, and changes initiated by the transition into parenthood. Some evidence shows that around 10% of new fathers experience depression, and yet this is still little understanding about this let alone appropriate support. Most new mothers perceive the father to be a crucial source of support. Poor paternal support can exacerbate maternal mental health problems. However, many fathers feel alienated and have little knowledge about how they can support their partner at this time.

These days, around 98% of fathers are present at the birth of their child. If that birth becomes traumatic, the father witnessing these events can also become traumatized. While research exists about the impact of birth trauma on mothers, little is known about the impact on fathers. Some evidence shows that fathers encountered ‘a rollercoaster of emotions, characterized by isolation and abandonment’ when witnessing their partners’ birth trauma. Previous studies have shown that fathers get little information and support in the event of a traumatic birth.

Fathers’ mental health matters for many reasons; we need to understand more about how we can help dads. My recent research has sought to explore that in more depth, while my campaigns urge better support for fathers. It’s not about support for fathers instead of mothers; it’s as well as. If we help fathers, we help mothers. If we help them both, we also help their children.

My research with fathers’ mental health

So far, my work has focused on three areas: what information and support fathers need to help their wife/partner should they experience poor mental health in the perinatal period; what support we need to give to fathers to deal with their own mental health in the perinatal period; and what information and support we need to give to fathers should their wife/partner experience what might perceived to be a traumatic birth.

Our research shows that fathers feel that they are not properly considered when it comes to providing information and support regarding their own postnatal mental health.

We are currently finalizing work on our research focusing on what support we need to give to fathers to manage their own mental health in the perinatal period, while the other two areas have been addressed in our recent papers in BMC Pregnancy and Childbirth.

What we found

Fathers and birth trauma

In our study of fathers who witnessed their partner’s traumatic birth, 61 fathers took part in a qualitative study that asked them to reflect on what information and support they were given. From those responses, three main themes were identified.

1.  Fathers’ understanding after the experience

Dads told us that ‘nothing could prepare them’ for the experience. One father said, “At no point was there any explanation to either my partner or myself to calm the situation.”

Fathers also confirmed that they felt the experience was ‘not about them’, as one dad expressed his exclusion:  “No. I’m the male. My presence was often not acknowledged let alone my feelings.”

2.  Life after birth trauma

Many fathers expressed concerns about what happened after the event:  “The trauma of my son’s birth put me immediately into what felt like sole-responsibility for my entire family 24/7, ultimately excluded me from colleagues and friends and I struggled to cope.”

The trauma clearly had an impact on many of the fathers’ mental health. One father told us he was “Upset, distressed and unable to cope very well. It was a feeling about the fragility of life during the birth and the overwhelming nature of the birth and the subsequent days.”

For some fathers, the traumatic experience had an impact on the relationship with their partner and infant. For example:  “I wanted to be with my wife but I felt guilty that I didn’t want to be with the baby. When I was with the baby I didn’t feel the level of love that everyone says you do and I felt guilty about that.”

3.  Support fathers received vs. what they wanted

Fathers told us that they were not getting that support from healthcare professionals. One father said, “I should have been more included from the beginning. A mother and father should both complete questionnaires regarding depression and a father should be asked how he is feeling or if there is anything that he wants to ask or doesn’t understand. These questions are solely aimed at the expectant mother whilst a father has to butt in and speak during a conversation he is only there to witness.”

Fathers supporting partner’s poor postnatal mental health

Our second study sought to explore fathers’ experience of their partners’ postnatal mental health. Twenty-five fathers took part in a qualitative study that asked them to reflect on what information and support they were given when their partner became unwell. From their responses to an online questionnaire, we revealed several important themes.

1.  Fathers not getting enough support

Focusing on the amount of support received, one father told us “I didn’t know how to help her.

Other fathers felt that any support given was of a poor quality. One commented that the support offered “…didn’t cover anything about the father and I felt lost.”

2.  Fathers not getting enough information

Fathers told us that they felt poorly informed. For example, one dad reflected on how he desired a “…basic understanding of depression and how to help when dealing with psychosis episodes.”

3.  Having someone to talk to

Many fathers would welcome having someone to talk to. One father explained how “… a specialist to sit with me and explain the situation and care plan” would have been useful.

International Fathers Mental Health Day is a global event illustrating why fathers’ mental health matters.

4.  Health professionals not taking fathers seriously

Many fathers said that they experienced very little help from the health professionals caring for their partner. One said, “My wellbeing was of little interest to midwifes, health visitors… I had not given birth so had no cause for sympathy. A leaflet for my wife and a page for the fathers to read which wasn’t enough

Global impact for fathers’ mental health

Overall, the outcomes from our latest research show that fathers feel that they are not properly considered when it comes to providing information and support regarding their own postnatal mental health, including the impact of birth trauma, and for helping their partner should she need support.

Today, June 22, is International Fathers Mental Health Day (IFMHD; the day after Fathers’ Day each year). In addition to research, my work involves campaigning for better perinatal mental health. I lead the UK side of IFMHD with global campaigner Mark Williams. IFMHD is led in the USA by Daniel Singley (The Center for Men’s Excellence) with support from Postpartum Support International. Bronwyn Leigh, Director of the Centre for Perinatal Psychology, leads from Australia.

IFMHD is a global event that shares blogs, videos, research and news items illustrating why fathers’ mental health matters. In recent years, truly powerful stories have been posted across Twitter and Facebook and we have featured in some noteworthy global print and broadcast media. Publicity and evidence from IFMHD and other research-led campaigning has enabled us to influence change in mental health support services for fathers, at least in the UK. Research by groups such as ours helped persuade NHS England to begin screening fathers for their mental health for the very first time. We hope that our new evidence, highlighted here, will have similar impact, perhaps even beyond the UK.

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