How we empowered dads to boost their children’s wellbeing

Public health nurse Heather Henry encourages fathers in a deprived area to learn coping strategies from each other.  Instead of focusing on needs - which can foster dependency - the 'asset-based approach' draws on the hidden strengths of men who manage to thrive in difficult circumstances

Little Hulton, on the outskirts of Salford, faces serious disadvantage passed down through generations. It is in the top 3% in the index of multiple deprivation for England. Fathers are sometimes marginalised in the matriarchal community and feel they have no value. Yet their children want them in their lives and fathers see in their children a purpose and reason for living.

Salford-based social enterprise Unlimited Potential was commissioned to use an innovative community development approach, led by me, called ‘positive deviance’ (PD) that has enabled fathers to find their own solutions to issues. What they have achieved is a source of great local pride. 

The PD process is about looking for fathers who succeeded given the same circumstances as everyone else and then spreading what they have learned from father to father. My role was to enable the process, to support but not to lead, because the solutions need to be owned by the community. The one thing I contributed as a nurse was confidence.

Tackling isolation

Using an action learning approach, Unlimited Potential found that pride prevented fathers from seeking help. Unlike women, when men have problems they tend to bottle them up and can become isolated. Some cope using drink and drugs, sometimes leading to crime and violence. We discovered exceptional fathers who talked openly about their problems – the ‘positive deviants’ – and they were able to help others discover they were not alone.

As the fathers’ well-being improved, so did the children’s (see John’s story below). The dads described it ‘like a mirror effect, we take how we feel into the home’.

Unlimited Potential started by helping the fathers to understand common issues affecting their well-being, and identifying the dads whose uncommon strategies enabled them to survive and thrive better than their peers – the ‘positive deviants’ from the norm. Unlike traditional service delivery, which focuses on assessing and responding to needs (a deficit-based approach that can foster dependency and passivity) the approach was asset-based, finding and using what’s strong, not what’s wrong.

We then sought ways to enable the community to understand this hidden wisdom and spread successful strategies. We aimed to take this further by reporting to commissioners on how services themselves respond to fathers and how they support or inadvertently hinder family life.

Positive reinforcement

I invented a competition called Men Behaving Dadly where children in eight primary schools explained in pictures or words why their father figure was the best dad in Little Hulton. The competition raised awareness of fathers’ positive role and was led and judged by fathers facing challenges. The effect on these fathers was startling and they rapidly increased in confidence, started meeting weekly and eventually became the independent, formally-constituted community group Salford Dadz.

The competition entries were thematically analysed. The children wanted to be loved by their fathers and to do fun things with them. In response, the fathers established a Saturday dads’ and kids’ club. This, and later initiatives, delivered non-stigmatising ways to bond with each other as well as their children.

Those fathers bonded because they were ‘all in the same boat’ and candidly shared what was happening in their lives. Slowly, with the team’s help, they came to realise that social isolation was the biggest presenting problem because male pride meant they bottled up feelings. The positive deviants spoke first, talking about their feelings, resulting in reciprocity and healing. In many cases I remained silent or absent, because I did not want to disturb the process. The dads saw they needed to change isolating behaviours and routines, so the project became about designing hooks to bring dads and children together.

Mothers’ scepticism

There were challenges. Some mothers were unsure about the change in the family dynamics as the fathers grew more confident, teaching each other to ‘rise above’ their label. The fathers realised they had not engaged mothers sufficiently and set about talking to them about their worries and holding ‘open days’ at their Saturday club. Slowly the mothers noticed that family life became happier as the fathers became more confident and took more of the burden of childcare.

The fathers’ main issue was confidence. This changed particularly during an exercise where they wrote on paper attached to each other’s backs what they valued about each other. Because many rarely heard what they were good at, the effect was profound.

The dads volunteered in the community, mending the church hall stage and painting walls for a homeless charity. These positive displays were noticed by the community and gave the fathers purpose and meaning. It allowed them to talk about what mattered ‘shoulder to shoulder’ while working. 

Facebook has played a huge role in informing the community about what is going on. One post asked local fathers to keep an eye on a community garden being vandalised. Two fathers caught two young boys smoking cannabis in the greenhouse. One boy had no father and lived in a children’s home. The dads responded by inviting the boys to play games on green spaces with them.

Evaluation

External academic evaluation by Leeds Beckett and Salford universities has found that children want to spend more time with their fathers and this time is precious, novel and enriching. They have seen a different side to their fathers and have new respect for them. Children have recognised their behaviour has changed in response and they too have developed an interest in helping others, recruiting and mentoring new members.

Importantly, children trust their fathers more and feel safer and more confident. They also feel valued and empowered. Comments include ‘Dad realised how much happier I was after he started Salford Dadz,’ and ‘When I grow up and have kids of my own I’ll bring them to Salford Dadz. I know what my dad’s done for me. Everything he’s done for me I can pass on to my kids. Some kids don’t get this.’

MIND has used Salford Dadz as a case study for commissioners and Unlimited Potential is a pilot site for NHS England’s Realising the Value programme, focusing on asset-based approaches. In addition, £340,000 funding has been secured from Lankelly Chase Foundation for replication over 3 years. We started in Winton, Eccles in January 2016 and we are there for 2 years. We are now looking for a third site to replicate the PD approach elsewhere in Greater Manchester.

I knew the fathers would have the answers – my role was to say ‘go on, you can do it’. I used to care for people. Now I care with them.

Evaluation findings

An independent analysis of social return on investment looked for changes in the 86 fathers who had been involved with Salford Dadz for at least 2 months. By the time the Unlimited Potential team left in December 2015, 25 men had changed their lives in some way, with a positive effect on their children, and the children’s mothers. The project has created social value as follows: 

• £1 invested yielded approximately £20 of social value

• Of which the potential financial return to the public sector is £1 invested yielding approximately £3 of potential savings 

• £1 invested yielded approximately £13 of value for about 25 of the fathers involved

These ratios are sensitive to assumptions made throughout the analysis. By making different, but still plausible, assumptions the social value is lower, with £1 invested yielding £13. Therefore we can be confident that the social value created by the project is in the range of £1:£13 and £1:£20.

Heather Henry is an independent public health nurse and a Queen’s Nurse. She is co-chair of New NHS Alliance