When my good friend Mark Williams asked me to write this blog for International Fathers’ Mental Health Day (IFMHD), I had no hesitation in agreeing. This is something very close to my heart, professionally and personally. Here’s why. Professionally, I am an academic psychologist (based at Bournemouth University), specialising in mental health (and particularly perinatal mental health). I campaign for better mental health provision for mothers, fathers, and the entire family. Personally, I am Dad to four (now adults), Granddad to four, and there’s another grandchild on the way.
Of course maternal mental health is important. I work with many groups across the UK to help make that a little better for mums. I help train midwives and health visitors on mental health. I am advising the NCT on their new perinatal mental health peer support service. I worked on the Best Beginnings maternal mental health project. I am part the 1001 Critical Days initiative. I am a member of the grassroots Perinatal Mental Health Partnership (which is part of the Maternal Mental Health Alliance). I work some of the most inspiring maternal mental champions across the UK. But, fathers’ mental health is important too.
I have worked with Mark Williams to try and establish a charity and support network for fathers. That work is ongoing. For me, fathers need support in two ways: to understand more about how they can help their wife or partner, should she develop mental health problems; and to protect their own mental health. To mark IFMHD 2017, Mark Williams and I recorded this podcast. In that I mention some of the work that I have been doing.
For some men, when their wife or partner develops a mental health problem (whether that be during pregnancy or after the baby is born), they lack the knowledge, resources, and confidence to know what they can do to help. Often, they feel the need to ‘fix’ it. Because the person they love is ‘sad’ they try to make it better by (perhaps) organising a holiday, or treating her to new clothes. That’s all very well, but it’s not understanding what’s really going on. Emotional support is vital. In some cases, when the mother develops a serious psychosis, or exhibits extreme obsessions and compulsions, fathers might become very scared of what is happening. Dads need to learn what to do and where to get support, but there are still too few resources to guide them. We need to change that. There are good resources, such as those provided by Action on Postpartum Psychosis, Bluebell, and the NCT. There is a need for more resources that are safe and reliable.
Also, health professionals and other support services (including charities and peer support groups) need to cater more for fathers (and dads-to-be). Some antenatal classes include dads, and some of those are now including emotional wellbeing and mental health (for both partners). However, that needs to be standardised (and benchmarked) and extended to all locations. Following campaigns (such as Maternal Mental Health Alliance, 1001 Critical Days, and others), the UK Government have been allocating funds to improve maternal mental health. We now need to exert more pressure to have more funding for fathers too.
Then there’s the work we need to do to support fathers’ own mental health. It’s hard enough to get men talking about emotions, let alone fathers. There is so much stigma about ‘manning up’ and being the ‘rock’. At the end of the day, it is perceived, it’s the man’s job to provide the security. But, chaps are vulnerable too. All sorts of factors can cause the father (and dad-to-be) distress. There’s the uncertainty of fatherhood, the sudden change in responsibility, financial concerns, and relationship changes to name just a few, and that’s quite apart from the sheer emotional turmoil. We need to make it OK not to be OK, and to be able to talk about it. We need to provide outlets to allow men to talk freely and without judgement. We need professional and support services to be better trained in how to support fathers (and recognise the signs that dad might need support).
A key area that I have been working on recently focuses on birth trauma. That trauma might relate to significant threats to life (for the mother and baby), major blood loss, birth complications, and unexpected outcomes (including unplanned caesareans). We already know that mothers need more support following birth trauma, and some great work is being done on that by the likes of Unfold Your Wings, the Birth Trauma Association, and the Birth Trauma Trust. However, not nearly enough is being done for fathers who witness that trauma. When there is a birth complication, understandably, the mother and child are the main priority in what might be a medical emergency. All the same, much more could be done for fathers. They are left to cope alone, with no information and (perhaps more crucially) no follow-up. We know that the way in which trauma is processed, and the level of support given, are major factors in whether a person develops post-traumatic stress disorder (PTSD). And yet, little is done to recognise that for fathers who have witnessed (often) very distressing scenes.
I know of one case, where a mother (in the final stages of labour) experienced significant blood loss following a placental tear. The father (who was present) only knew there was an emergency when the delivery team hit the alarm (to get more help). He was given no information. Not even a brief explanation of what was happening. He was simply given his new son and told to ‘get on with it’. When his mother-in-law (alerted to the emergency) entered the room, he was seen to be visibly shocked and deeply distressed. The emergency was dealt with, and the mother and baby were fine. However, the father was never followed up to check the impact of witnessing that trauma.
We need to ensure that information and support is more readily available. However, before we can demand that, we need to know what fathers need. There is too little research to date. To address that, I have started some work in this area. Under my supervision, one of my undergraduate (final year) psychology students (Emily Daniels) undertook a research project. We recruited fathers who had witnessed birth trauma. We asked them about that experience, what information they were given, and what support they received. The formal results will be published soon, but we do know that fathers were saying about how little information and support they got. We will use that evidence to inform agencies to help change this lack of support. The work has already received some media attention, through newspapers (e.g. The Times) and BBC Radio and TV. Bournemouth University made this short video about the work. We will be extending the work in the near future.
In the next academic term (Autumn 2017), I will be starting two new projects on fathers’ mental health: one that explores what resources dads need to support the wife/partner’s mental health; and one that examines what help fathers need to support their own mental health.