The mental well-being of fathers and partners
Research type
Research Study
Full title
The mental well-being of fathers and partners of women accessing perinatal mental health services
IRAS ID
291920
Contact name
Vaheshta Sethna
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
0 years, 6 months, 14 days
Research summary
Summary of Research
Fathers/partners are at risk for developing mental health problems during the perinatal period (i.e. whilst their partner is pregnant and after their baby is born). We define partners as the person identified by the mother as their
partner. This could be any co-parent including a father, co-mother or co-father. The study will screen partners for common mental health problems including anxiety, depression and PTSD using online questionnaires. The screening questionnaires will help us to understand the mental health needs of fathers/partners of women who are being cared for by perinatal mental health services. This will also help us see if partners are happy to complete these kinds of questionnaires online.In the study we will recruit three different groups of partners. One group will be partners if the mother is being treated in a Mother and Baby Unit. The second group will comprise partners when the mother is being treated in community services (i.e. an outpatient clinic). The final group will be partners if the mother doesn’t have a mental heath difficulty.
Initially, fathers/partners will be approached when they attend services with the mother. They will then be contacted by the researcher who will provide more information about the study. Fathers/partners will then be sent the screening questionnaires to complete online. The results of the screening will be confidential; however participants will be given the information for relevant mental health services they can access if their responses indicate they are experiencing a significant level of emotional distress.
The study will help to inform our understanding of whether fathers/partners are happy to complete mental health screening questionnaires. It will also help to identify if fathers/partners are more at risk of developing mental health difficulties if the mother is also experiencing a mental health difficulty.
Summary of Results
This research was carried out as part of the researcher’s doctorate in clinical psychology and was sponsored by King’s College London. When designing the research, we consulted with a parent advocate as well as a Patient and Public Involvement board. The study took place between June 2021 and May 2022.
Background
Fathers’ and partners’ mental health is not routinely screened during the perinatal period despite increased risk at this time. Given that fathers play a crucial role in supporting maternal wellbeing and in the development of their offspring, the NHS long-term plan has set ambitions for implementing screening and signposting of fathers and partners of women accessing perinatal mental health services. However, this has not been implemented in all services and it is not clear what the uptake of screening would be.
Moreover, there is limited research focusing on the views of clinicians on engaging fathers and partners in perinatal services, and existing studies have largely focused on clinicians working in universal services as opposed to specialist perinatal mental health services. Current research with health visitors and midwives (Whitelock, 2016; Rominov et al., 2017) identified specific barriers to father/partner involvement in services including: a lack of confidence and service constraints including large caseloads and workloads. However, the views of clinicians responsible for screening fathers and partners, in specialist perinatal mental health services, remain understudied.This NHS based study was conducted in two parts.
Part one examined the feasibility of screening mental wellbeing and couple satisfaction in fathers and partners of women accessing an inpatient Mother and Baby Unit (MBU) and community perinatal mental health teams within an inner-city NHS Trust.Part two involved two focus groups with nine clinicians working across these perinatal mental health teams (i.e. the MBU and community perinatal mental health teams), using thematic analysis to investigate their views on engaging fathers and partners.
Part 1: The feasibility of screening fathers and partners mental wellbeing Methods Potential participants were either approached directly by clinicians, when they joined an assessment or intervention session, indirectly through the mother or through a recruitment poster sent to families by administrators. Fifty fathers and partners were recruited overall. Ten participants were recruited from an inpatient Mother and Baby Unit), 12 from community perinatal mental health services and 28 were fathers and partners of women who were not accessing mental health services. Participants completed online screening questionnaires about their mental wellbeing (i.e. symptoms of depression, anxiety and birth trauma) and couple satisfaction.
Results
The study reported that fathers and partners who were approached in an inpatient setting (the Mother and Baby Unit) were more likely to engage in the study than fathers and partners approached in community perinatal teams - 10 out of 14 fathers and partners approached on the MBU completed the screening, whereas only 12 out of 212 approached in community perinatal mental health teams participated. This may be because fathers and partners in an inpatient setting were approached directly by a member of staff whereas in community teams, some participants were approached through the mother or a recruitment poster.Fathers and partners who were recruited from the Mother and Baby Unit had the highest scores on all screening measures (indicating more symptoms of depression, anxiety or birth trauma) compared to fathers and partners recruited from community perinatal mental health teams and those from the control group. This may suggest that this group is at a higher risk for mental health difficulties during the perinatal period and would therefore benefit from routine screening. However, further research with a larger sample is needed to investigate whether this difference is also found across different NHS trusts.
Part 2: Focus groups with clinicians from perinatal services Methods Nine clinicians (including doctors, nurses, psychologists and allied health professionals) from perinatal mental health services (inpatient and community) participated in two online virtual focus groups. The focus groups asked clinicians their views regarding: 1) engaging fathers and partners in assessment and onward signposting; 2) understanding the benefits and barriers to engaging fathers and partners in perinatal mental health services.
Results
The focus group results showed that clinicians saw the value and benefits of including fathers and partners in perinatal services. They held beliefs about the importance this held for the mother and baby. However, concerns were raised regarding the available resources, practicalities (such as how the father/partner would be recorded on the clinical notes system and how this would be balanced with already high caseloads) and accessibility of services in their current format (i.e. Monday to Friday 9-5). This suggests that although clinicians recognised the importance of engaging fathers and partners in perinatal mental health services, the identified barriers should be considered before routine screening is implemented.Overall summary
This study found that fathers and partners who were approached in an MBU setting to participate in research on mental health screening participated at a higher rate than fathers and partners approached through community perinatal mental health services. Although all the participants who consented completed all of the questionnaires, the small number of fathers and partners who consented to participate overall suggests that the methodology may not have been acceptable to some fathers and partners. Future research with a larger sample should be conducted to further investigate group differences to determine whether some groups of fathers and partners are at a particular risk for mental health difficulties during the perinatal period and therefore would benefit from routine screening.Perinatal mental health clinicians who participated in two focus groups seemed to agree that the screening of fathers and partners is important. Clinicians saw the value in involving fathers and partners in perinatal services and held beliefs about the significance of this for the family which seemed to make a difference in their behaviour and willingness to adapt their practice. This study suggests that further work may need to be done to address existing barriers to routine screening of fathers and partners in perinatal mental health services such as a lack of resources and accessibility before trying to implement routine screening for fathers and partners of women accessing these services.
REC name
South Central - Oxford A Research Ethics Committee
REC reference
21/SC/0136
Date of REC Opinion
22 Jun 2021
REC opinion
Further Information Favourable Opinion