Fast-tracking help for paternal post-natal depression

Let's help the thousands of fathers silently struggling

Earlier this summer I emailed Stella Creasy—MP for Walthamstow and a fearless defender of parental rights—to see if she could help with a problem. As you might know, I’ve struggled with paternal post-natal depression and (based on the emails I receive from other dads out there) know these issues have gotten worse over the last 18 months. I believe health authorities around the world need to act immediately to help the thousands of fathers who are silently struggling with this problem. I need your help figuring out what to do next.

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Dear Stella

I felt compelled to write to you because I'm increasingly worried by a mental health crisis affecting men across the UK—and probably the whole world—that's flying underneath the radar.

After the birth of my second child, I knew something wasn't right. I felt like I was making my way through mud, with a 50kg weight strapped to my back. I didn't want to see friends, family, or even hold my son. I'd go and walk the dog, and sit outside, crying on a park bench.

In trying to understand what was happening I came across this article, written by a doctor who had trouble connecting with his second child. I read it, and it was like a mirror to my own experience: Ongoing feelings of anger towards your partner and child. Feeling numb and empty. Increased irritability. Increased use of alcohol. Significant weight gain or loss. Loss of interest in work or hobbies. Feeling sad and crying for no reason.

I read the symptoms, and felt an odd sense of relief. Paternal post-natal depression. A mental health disorder affecting new dads. I started doing more research on what it was, and how to get better (I wrote about it here). My experience inspired me to start The New Fatherhood, a community where men could talk to other men about the feelings and emotions brought on by fatherhood. This led to more conversations with more new dads about this, and the realisation that this is a huge problem. Since sharing my story I've had dozens of emails and messages from men (and their partners) who have found themselves in a similar place, with nowhere to go:

"Reading your story made me relive those first years and I cried together with my wife. I think I finally made peace with the fact I DO suffer from paternal post-natal depression and immediately went on to look for therapists and create structure based on the toolkits you mentioned."

"Your writing about paternal post-natal depression really hit a nerve … My husband suffered from this after our daughter was born and even though I spoke to health workers about it, they simply did not want it on their radar and they were very clear in their opinion that the fathers health and wellbeing was simply not their concern. He wouldn’t get help – and people were unwilling to help."

"When talking to other dads most of them were like “suck it up, you have a wife to care for!”. Which wasn’t very good advice for my situation. Very grateful for you Kevin and all the other dads on here opening up. In fact it’s the first time opening up to a group of strangers for me also."

Whilst PPND is not as widely acknowledged—or well-researched—as post-natal depression in mothers, latest figures indicate it could be as high as 25% of new fathers (or 50% for those whose partners also suffer from post-natal depression.) This is particularly troubling as men are less likely to seek help, or to reveal negative thoughts to partners, friends, or healthcare professionals.

Assuming the 2019 ONS figures of 640,370 new babies born in the UK (and removing 12.8% of lone-parent mother households) there are around 558,000 new fathers in the UK each year. If research is correct is saying up to 25% of new fathers will deal with PPND, then that could mean as many as 139,500 men, each and every year.

Researchers have found harmful effects of PPND on childrens’ cognitive development, and children of depressed fathers are twice as likely to develop a psychiatric disorder by age 7. A recent study said "The effect of PPND on early childhood has been evaluated by researchers around the world showing emotional and behavioural problems, lower social and psychological well-being, and internalising behaviour problems in children aged three to 12 years."

This problem is not as well known and researched as maternal post-natal depression, but I have attached some of the latest research to this email. There isn't a silver bullet to fix this. But one thing that consistently came up in the research was a need to diagnose this earlier through increasing screening.

Since 1987, hospitals have administered the Edinburgh Postnatal Depression Scale (EPDS) to all new mums to find indications of post-natal depression. I'm sure you were asked those 10 questions yourself. There are early indications that this scale would (with a lower cut-off score, to account for a reluctance to share symptoms) to detect PPND in new fathers.

The NHS 10 year plan indicates they will start "offering fathers/partners of women accessing specialist mental health services [...] to care for the 5-10% of fathers who experience mental health difficulties during the perinatal period". But there's no timetable for this plan.

I'd like to ask for your help in fast-tracking the usage of the EPDS for all new fathers in the UK.

I believe this change could have national impact at a minimal cost to the NHS. I know this isn't "free" — it will be asking even more of the nurses, midwifes and GPs who have done so much for us over the last 18 months. But the cost of not doing is so much higher

I had PPND. I know how hard it is. How it rips families apart. How it makes men resent their children—maybe forever, at the most wonderful time of their life—because they don't get the help they need. I'm lucky this happened with my second child, and I had the inclination to find out what wasn't right. But there are thousands of undiagnosed dads, silently suffering, unsure of why they feel the way they feel. Taking it out on themselves. Their partners. Their family and friends. And—worst of all—on their children.

Thank you for reading this.

Regards,

Kevin Maguire

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Stella sent this email onto Nadine Dorries, who was, at that time, the minister in charge of Mental Health in the the UK.

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Dear Stella

Thank you for your correspondence of 23 July on behalf of one of your constituents about paternal postnatal depression.

I read your constituent’s New Fatherhood newsletter with interest, and I commend him for his efforts in helping and supporting other fathers going through similar experiences to his own.

We do recognise that postnatal depression does not only affect women, and that research shows that up to one in ten new fathers become depressed after having a baby.

We are committed, through the NHS Long Term Plan, to expanding and transforming mental health services in England and to investing an additional £2.3billion a year in mental health services by 2023-24. As part of this the NHS is improving access to, and quality of, perinatal mental health care for mothers and their partners. This includes improving access to evidence-based psychological therapies; mental health checks for partners of those accessing specialist perinatal mental health community services and signposting to support as required.

I am pleased that in April this year, the NHS announced that twenty-six new perinatal mental health hubs would be opening in England. These hubs will offer physical health checks and psychological therapy in one building. They will offer treatment for a range of mental health issues from postnatal depression to severe fear of childbirth to around 6,000 new parents in the first year. Ten of the hubs will be set up in the coming months, with the remainder due to open by April 2022. It is expected that all areas of England will have access to a hub by April 2024.

We recognise that there is still work to be done in this important area, but I am pleased to say that we are making good progress.

I hope your constituent will find this information helpful, and I would like to wish him well with his New Fatherhood newsletter and website.

Nadine Dorries

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I’m sending this to you all because I am wondering what to do next. The reply didn’t fill me with hope, seemed to ignore the recommendation I suggested, and had no specific commitment to supporting new fathers with their mental health problems.

This small group contains some very smart people, and I’m open to suggestions. Let me know if anything comes to mind—comment, email, and I’ll start a thread in Geneva. And if there’s anyone you know who might be able to help, please forward this email on to them.

— Kevin