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Mental health and well-being: why supporting new fathers is crucial

Historically, healthcare has focused mainly on maternal health – but the emphasis on family mental well-being from birth highlights the need to ensure fathers are involved in interventions to promote their own welfare

Historically, healthcare has focused mainly on maternal health – but the emphasis on family mental well-being from birth highlights the need to ensure fathers are involved in interventions to promote their own welfare


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There has been increasing and welcomed interest in the mental health of children and young people in the last few years. To meet the ambitious targets for community provision for children and young people as outlined by the Mental Health Taskforce (2016), a systemic approach is needed.   

The King’s Fund (2018) highlights the stark realities for the nation’s mental health: ‘More than half of all mental health conditions in adulthood are established before the age of 14’. While recognising the importance of school interventions, it identified the biggest gap in provision in pre-school age children.

‘As men can present with traditional and more externalising symptoms of depression, it is vital that practitioners are aware and can act on these observations’

An emphasis on family mental well-being from birth is needed. Historically, care has focused mainly on maternal health, which does not consider the whole family unit.

Paternal depression

There are widely acknowledged risk factors for young people’s well-being if maternal depression occurs. There are, however, few studies relating to paternal risk. Lewis et al (2018) undertook a large cohort study in Ireland and the UK. The findings are important for primary care practitioners: the risk of depression in adolescence from paternal depression was found to be significant and independent of maternal health. The authors said: ‘Most fathers reported both traditional and depressive equivalent symptoms’ and require screening tools adapted to meet these specific needs. 

Andre Tomlin’s blog Should we screen new dads for Depression? talks of his own experiences and relates symptoms such as feeling without a role, irritable, angry or frustrated. Lewis et al (2018) highlighted the need to ensure fathers are involved in interventions to promote their own mental well-being, to reduce the associated risk to the adolescents of the future.

‘Screening tools in maternal health are well established; we need the equivalent for fathers’

The idea that whole family mental health needs to be considered in relation to children and young people’s health is not new. This recent research expands further the discussion and increases the evidence base for practitioners to inform contact with families and specifically new fathers. Each individual will present with unique experiences. 

Holistic interventions

The need for holistic and systemic interventions to support the whole family is clear. As men can present with traditional and more externalising symptoms of depression, it is vital that practitioners are aware and can act on these observations. Screening tools in maternal health are well established; we need the equivalent for fathers. 

The perceived need to screen fathers’ mental health led to Psouni et al (2017) trialling existing tools, including the Edinburgh Postnatal Depression Rating Scale (Cox et al 1987).  This initial research did not meet the necessary thresholds for sensitivity or specificity. However, Psouni et al (2017) suggest exploration of a hybrid screening tool.

Regardless of any screening tool being available yet, these findings can inform practice on family well-being. Nurses working in primary care are well positioned to have these discussions, whether planned or opportunistically.

The first step to supporting this group of men is through encouraging men to recognise when their mental health and well-being changes, to be confident to express how they are feeling and to know they are not alone.

Practitioners need to be aware and to recognise, support, screen and signpost to local support groups or talking therapies. 


References


About the author

Pam Hodge is lecturer in practice learning at Middlesex University, London

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