Lecture 7- Fathers Mental Health

Question 1

why is Fathers supporting wife/partner through perinatal mental illness important?

Answer 1

potential causes of PND 
Having had depression before
Not having a supportive partner 
Having a premature or sick baby 
Having lost your own mother as child 
Having had several recent life stresses

Question 2

describe the Elaine Hanzak (2016) study

Answer 2

asked mums, who had experienced maternal MI, how much their partner was able to help
Not helpful…
… he said ‘postnatal’ only applied in first few weeks…
… no support… when I stated I was exhausted, the response was ‘so am I’
Did the best they could…
He was as good as he could be
Helped a lot – but maybe not in the right way
…he just did not know what to do
… he was also depressed
Other partners in the Hanzak study were more helpful
One mum said…
… (he) stopped work to help me… bonded with baby… endlessly patient… supported me when I cried and cried… went with me to see GP
But, in many cases, fathers simply do not have the support and information to know how to help
Mark Williams (leading UK campaigner, fathers MH)
Happy marriage… baby born… it all changed
… thought it was his fault… didn’t want to tell anyone… baby might be taken way

Question 3

tips for fathers supporting wife through mental illness

Answer 3

tips from Smile Group (supporting partner with MI)
Understand PND is an illness
Seek help and do very best to understand the illness
Be there (emotionally), offer a shoulder to cry on, a hug when you come home
Encourage partner to talk about their feelings
Try not to judge… listen, even if you can’t understand
Help with the practical things
Encourage healthy eating
Encourage relaxation
Be patient – recovery can take time
… but PND is treatable with the right support
Make sure you have time out for yourself
Or you might become unwell

Question 4

Can fathers develop postnatal mental illness?

Answer 4

Plenty of anecdotal evidence, but little research
10.4% of fathers depressed before and after the birth (Paulson & Bazemore, 2010)
Fathers with ‘PND-like’ symptoms 47x more likely to be suicide risk
Than symptom-free dads (Quevedo et al, 2011)
But is that truly ‘PND’?
What we do know is that around 15% of new fathers have partners with PND (Matthey et al, 2000)
Impact of ‘fathers’ transition into parenthood’ largely overlooked (Condon et al. 2004)
Men are less likely to seek support (Berger et al, 2013)
PND-very little of the cause is hormonal- educational, social etc (all things that can effect dads too)
When children are born testosterone drops who knows what effect that can have?
Fathers effect mental health issues that impact themselves, their partners and their babies

Question 5

Massoudi 2013: describe this study:

Answer 5

Excellent thesis on fathers’ mental health in the perinatal period
Prevalence of ‘depression’ in new fathers
Evidence varies across studies depending on sample, measures used, and time point
But seem to be significantly lower than the rates for women
UK: 4% of dads in community sample (Ramchandani et al, 2005)
Brazil: ‘depression symptoms’ 12%; 4% moderate to severe (Pinheiro et al, 2006)
USA: ‘symptoms’ in 10% dads at 9 months postpartum (Paulson et al, 2006)
But around 5% when using diagnostic criteria
Massoudi suggests that ‘formal PMI’ is not seen as relevant to dads
Despite evidence ‘fathers’ mental illness in the postnatal period’

Massoudi 2013 sought to examine (in Swedish population)
Explore how child health nurses worked with fathers
How much support they offered in clinics
Edinburgh Postnatal Depression Scale (EPDS) frequently used (internationally) with mums- does this work on dads? Needs more research/unproven
But is it sensitive enough to detect problems in dads?
Picking up diagnostic criteria for symptoms
Examine prevalence of depressive symptoms in fathers and mothers 3 months postpartum

Question 6

what did Massoudi (2013) find?

Answer 6

Most nurses rarely noticed if a father was distressed
Fewer than 1 in 5 nurses offered supportive counselling to fathers in previous year
Around 50% were ambivalent about fathers’ caring capacities
Factor structure of EPDS (for men) showed greater emphasis on ‘distress’ than ‘depression’
Comparing EPDS outcomes to known diagnoses in men
Accuracy modest for minor depression
And low for anxiety disorder
Depressive symptoms 3 months postpartum (EPDS score 12+)
6.3% in fathers; 12.0% in mothers
Specifically for fathers:
Major depression 1.3%; 6.1% minor depression
Strongest correlates of depressive symptoms in fathers
Problems with partner relationship (including low perceived support)
History of depression
Experiencing two or more stressful life events in past year
Poorer education
Willingness to seek treatment
Only fathers with major depression were keen to get treatment
Several were already getting help
But remaining fathers less keen to seek support
Anxiety disorders
Minor depression
General distress
But these are the very men we should be helping
Avoid escalation