This evidence review explores paternal perinatal mental health, including the factors affecting paternal perinatal mental health, those most likely to be affected, sources of support used by men during the perinatal period and barriers which might impede men accessing support.
Introduction
Policy context
Looking after the health and wellbeing of new parents and their babies is paramount. As part of this, the Scottish Government is committed to supporting the wellbeing of fathers and partners during the perinatal period. Since 2019, the Scottish Government has overseen a significant investment in improvements to mental health services and support for parents, infants and families across Scotland. This includes investment into the development of specialist community perinatal mental health services, maternity & neonatal psychological interventions services, infant mental health, mother and baby units and services provided by the third sector such as counselling and befriending. Each of these has a remit to consider the needs of fathers/partners in the provision of services. Through the Perinatal and Infant Mental Health Fund and Small Grants Fund, funding is provided for both father specific and whole family work, including funding for peer support groups for new fathers, which can provide a valuable source of support. A variety of information and advice is provided on Parent Club, including content specifically focussed on the needs of new fathers.
The perinatal period and perinatal mental health
There are varying definitions used in research regarding what constitutes the perinatal period in relation to mental health. Some studies include the first year following childbirth (Conteh et al., 2022; Leach et al., 2016) or up to the second- or third-year post-birth (Canário & Figueiredo, 2017). This report uses the definition from the Scottish Intercollegiate Guidelines Network's (2012) National Clinical Guidance on the Management of Perinatal Mood Disorder, which defines the perinatal period as encompassing both the antenatal and postnatal stages (i.e. from conception to the end of the first postnatal year).
Perinatal mental health refers to the emotional wellbeing of women, their children, partners and families during the perinatal period. Mental health problems during the perinatal period are recognised as a public health concern which can have a significant and lasting impact on the whole family (Bauer et al., 2014).The perinatal phase is especially significant for parents' mental health because becoming a parent can adversely affect both their mental health and the health of the family unit (Darwin et al., 2017).
Men's perinatal mental health
While the mental health needs of mothers during the transition to parenthood have received increasing attention in research, policy and service provision, the needs of fathers have not been examined to the same extent. (Fisher et al., 2021). There is also limited awareness of the topic of paternal perinatal mental health amongst both men and women in the general public, compared to awareness of maternal perinatal mental health (Swami et al., 2019). In recent years, however, the mental health needs of fathers have been increasingly recognised, with research showing that men's mental health can be adversely impacted by the transition to parenthood and they can develop specific mental health needs.
To support men's mental health and wellbeing during their transition to fatherhood it is essential to understand their experiences and the specific needs they may have during this period. This is important both in terms of the impact on fathers themselves as well as their partners and children. For example, fathers have an elevated risk of depression and anxiety disorders during the perinatal period that is associated with maternal depression. Paternal mental health is also associated with child mental health and developmental outcomes starting from infancy and continuing through the lifespan (Fisher et al., 2021). However, fathers are infrequently screened, diagnosed, and treated for mental health conditions during the perinatal period due to a lack of relevant awareness and training about paternal perinatal mental health among healthcare staff (Musser et al., 2013; Singley & Edwards, 2017).
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