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Are they missing a trick by not including Dads in Nice Guidelines?

Whilst reading the newly published IAPT (Improving Access to Psychological Therapies) manual this week, I couldn’t help thinking they’d missed a trick. It’s great to see the ‘Antenatal and Postnatal Mental Health NICE Guideline’ quoted and reference made to perinatal priority for mums, but what about Dads, partners and other loved ones who may have been birth partners? The inclusion of those two words ‘and partners’ could have brought about a small but significant revolution in the offer of psychological therapy to men in this country. Our IAPT teams in South Staffordshire offer perinatal and postnatal priority to dads and partners too, up to their baby being a year old, not because we are required to, but because we think it’s discriminatory not to.

Dads and partners play so many essential roles in the family throughout pregnancy, birth and the early days of their child’s life. If they are depressed, fatigued, lacking in motivation, or unable to engage with their partner, baby’s or older child’s emotions – what effect on their family? What if they develop perinatal OCD to the extent they cannot cuddle their precious child or change their nappy for fear their intrusive thoughts are true and they really are a paedophile? What if they have witnessed their partner going through a traumatic labour, or have known the fear of losing them or their child when things didn’t go to plan?

All terrible but sadly common situations. Health visitors and midwives will ask mums about their emotional wellbeing after a birth, but in reality most dads may not be present at those appointments for their needs to be considered, or if they are, the questions are not directed to them. It’s not made easy for men to say they need support and yet having a baby is one of, if not the biggest event in anyone’s life, male or female.

It’s why our service is making a big deal of Men’s Health Week this year. June 18th is International Fathers’ Mental Health Day with the aim of raising awareness around the world that dads need support too. It is suggested that around 10% of dads can experience mental health problems in the first year after their child is born but many cannot access the help they need or are not asked if they are OK. I would probably suggest that figure is higher as issues are likely to be under reported.

We are going out in the community to let men, and specifically dads, know that we care if they are not OK. Evidence based therapies can be so effective and more so if delivered early. If dads find it hard to ask for help then services should be going out to find them and make it easier for them. This Men’s Health Week we will be in gyms, shopping centres, leisure centres and libraries starting conversations about emotional wellbeing and giving out free information, wellbeing checks and offers of therapy.  We provide computerised and telephone therapy for people who can’t or don’t want to see someone face to face. We provide two clinics a week until 8pm and start at 8am every day so that people don’t have to take time off work. We engage on social media to make ourselves easier to find. We run clinics in supermarkets and fire stations to make it easier to get through the door. There’s a lot of good practice going on all around the country but it shouldn’t be left to chance, we should be proactively planning it into models of care, both in mental and physical health.

I was talking to a dad in our waiting room recently, beautiful baby on shoulder, waiting for his partner to finish her therapy session. I asked how things had been for him since the birth and he looked truly shocked that I would even consider him. Let’s move towards a culture in all health services where it’s a routine question to men because until we all ask it, men will continue to feel they have to say they are OK and can’t come forward for support.

When the IAPT Manual is revised, I’d love to see dads included in the first line, in the priority category with mums. I’d also love to hear from anyone who has suggestions for services to help us increase our reach to more dads. The effect on our children and our wider families of their dad not being ok as they grow up is too big an issue for us to continue to ignore.

Dr Sarah Watts is Clinical Lead for Midlands Partnership Trust South Staffordshire IAPT teams. She is a Consultant Clinical Psychologist by background and has two children of her own. You can follow her on Twitter @ClinLeadWBM

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