Promoting fathers’ mental health and father involvement – a call to action is given here by Deborah Da Costa, Ph.D., Associate Professor at the Department of Medicine, McGill University, and Scientist at McGill University Health Centre
Up to 1 in 10 fathers struggle with mental health difficulties during their partner’s pregnancy and/or the first year following the birth of their child. Depression is among the most commonly experienced mental health difficulties for fathers during this life stage. The use of a gender lens is important to recognize the signs of depression in men, as they can exhibit symptoms differently compared to women.
Men may be more likely to withdraw, experience physical symptoms like headaches, abuse substances such as alcohol and cannabis, and become more irritable and prone to anger outbursts.
Fathers’ mental health
Several factors have been identified as increasing the risk of poor mental health outcomes for men during the transition to parenthood, including a history of mental health difficulties, financial stress, low social support, poor sleep quality, dissatisfaction in the couple’s relationship, and having a partner experiencing psychological distress. Many of these factors are modifiable and can be targeted early on to prevent mental health problems and promote emotional well-being in men during the transition to parenthood.
Untreated mental health difficulties in fathers during the perinatal period have adverse consequences on the father, their partner, and the child. The adverse effects on child development associated with paternal mental health difficulties are well documented and extend into adolescence. Despite the prevalence and negative impacts of mental health difficulties on fathers during this critical life stage, they remain under-studied, under- recognized, and under-treated.
Patriarchal masculinities dominant in many societies across the globe can negatively impact the mental health of men, women, and other gender identities. They impact access to mental healthcare and the availability and quality of gender-sensitive care and resources in the community. Boys, for example, are raised to believe that their role as fathers one day is to provide, protect, and be strong as the head of the family. Still, now they are also expected to be involved in their children’s caretaking much more than prior generations.
As a result, many feel ill-prepared and have lacked role models growing up of fathers who match current expectations, which can cause excess parenting stress, low confidence in parenting skills, worry, and feelings of guilt. These experiences can increase the risk of mental health conditions, such as depression and/or anxiety, during the transition to parenthood and early parenting years.
Fathers’ mental health: Promoting father involvement
In the last two decades, it has become well-established that fathers have a profound and unique influence on child cognitive, social, emotional, and behavioral development. The transformative process of becoming a father begins during their partner’s pregnancy, as the antenatal period is the starting point of the parenting journey.
Fathers’ involvement during pregnancy has been conceptualized as their supportive attitudes and behaviors toward their partner during the pregnancy and by the direct and evocative experiences with the unborn child. These include activities like attending doctor visits, sharing decision-making related to the pregnancy, seeking out pregnancy-related information, feeling the baby’s movements, and having images of interacting with the baby.
Having a partner who is engaged in the pregnancy may increase maternal perceptions of parental togetherness in the pregnancy, as well as perceptions of the partner as dependable and supportive, which in turn could optimize maternal outcomes. Father involvement during pregnancy is thus viewed as playing a distinct role in the support of mothers during pregnancy.
For married and cohabitating women, partner support appears to be uniquely beneficial. It may have a greater impact on reducing the risk of postpartum depression compared to support from family and friends. Emerging findings from the evidence-base show an association between higher levels of fathers’ engagement in their partner’s pregnancy and healthier maternal behaviors, including earlier antenatal health care, better utilization of maternal health services, reduced cigarette consumption, antenatal class attendance, the decision to breastfeed, and higher levels of psychological well-being.
Fathers’ antenatal level of engagement has also been shown to be strongly associated with fathers’ postpartum level of involvement with their child across various dimensions, including childcare, health, play, and affection.
Collectively, these findings suggest that facilitating father involvement during the antenatal period may be important to optimizing maternal health and establishing positive father-infant involvement patterns likely to be sustained over time, with important implications for healthy child development. More studies are needed to better understand the specific barriers and facilitators of fathers’ engagement during their partner’s pregnancy so that interventions can target the most significant modifiable factors and vulnerable groups.
As a society we need to facilitate father involvement starting in their partner’s pregnancy and across their child’s life. We need to normalize that parenting can be challenging for both parents, which is okay; in fact, it is crucial to seek support and access resources as needed.
We need more public health messaging through social media and other outlets where men attend (e.g., workplace, sports clubs, and gyms) to promote good fathering practices, to promote self-care (e.g., exercise, stress-management practices, eating well, making time for quality sleep) and safety around seeking mental health resources and other sources of support such as connecting with other dads.
Funding must be allocated to make resources affordable and accessible for those with less financial means and/or time constraints due to work responsibilities.
Policies around paid paternity leave in many countries need to be improved so that fathers can have an opportunity to bond with their child, support their partner, and partake in caretaking without fear of losing their job or concerns about the financial impact.
We need to do better to support fathers who may be more vulnerable to mental health difficulties during this period and/or have more obstacles to their involvement during the parenting journey, including single/divorced/widowed fathers, ethnic minority fathers, and same-sex parents.
Fathers matter: The necessity of protecting fathers’ mental health
Fathers matter, and thus, to enhance support systems in the community. As a society, we must do better to understand and value the role of fathers equitably, inclusively and across diversities. My research program seeks to facilitate this understanding, and I will continue to advocate for fathers across the diverse constellations of parenting.
