Supporting Fathers Affected by Postpartum Depression in their Partner: Results of a Pilot Study

1. Supporting Fathers Affected by Postpartum Depression in their Partner: Results of a Pilot Study Principle Investigator: N. Letourneau (nicolel@unb.ca) Presenters: T. Cluney, C. Hauer (carolhauer@familiesmatter.ca ), M. Weeks (weeks.murray@rvh.nb.ca ) Academic Team: M. Stewart (AB), K. Hegadoren (AB), C. L. Dennis (ON), L. Duffett-Leger (NB), A. Doucet (NB) Additional Contributors: P. Tryphonopoulos, J. Donovan Fatherhood Involvement Research Alliance 2008: Diversity, Invisibility, Community WHRU

2. National Advisory Committee Members NAC Chair: Carol Hauer (Calgary) Members • New Brunswick: Tim Harvey, Murray Weeks (Fredericton); Derek Jones (Saint John) • Alberta: David Este, Dr. Robert Pogue, Dr. Lorraine Natho (Calgary); Judy Evans, Linda Duffley, (Edmonton); Janine Neyedley (Sylvan Lake); Corrie Ryhasen-Erdman (Stony Plain) • Ontario: Ed Bader, Tim Paquette, Bill Watson (Toronto); Neil Campbell (London); John Hoffman (Guelph); Bill Watson (Niagara) • British Columbia: Linda King (Vancouver) • Yukon: Nancy Gray (Whitehorse)

3. Presentation Overview • DADS Pilot Study findings • Description of support programs for fathers • Professional/Personal experience of paternal PPD

4. Background and Objectives of Study • In an earlier CIHR-funded study, mothers reported that fathers were primary source of support . • We sought to explore the following questions: • What are fathers’ experiences with coping with PPD in their partner? • What are fathers’ personal experiences with PPD? • What are fathers’ support needs? • What are fathers’ support resources? • What barriers do fathers encounter in supporting their partners with PPD? • What support interventions do fathers prefer for themselves and their partners?

5. Description of Participants • Mean age = 37 • English primary language • NB, n=7; AB, n= 4 • Pregnancy planned, n=7; pregnancy unplanned, n=4 • 1st pregnancy, n=6; multiple pregnancies, n=5

6. Fathers’ Experiences Coping with Partners’ PPD • 3 fathers did not realize partners needed professional help. “…that’s my own ignorance. I didn’t know what I was looking for. I didn’t recognize there was as much of a problem …”(DAD_09) • Coping behaviours: • digging for information • escaping to work • minimizing symptoms

7. Fathers’ Experiences Coping with Partners’ PPD • 9 fathers experienced fear & worry for partner “…the feeling of like I wasn’t able to help her just because I wasn’t—I couldn’t—I didn’t really understand why she couldn’t sleep so and didn’t understand how bad her anxiety was.” (DAD_06). • 6 fathers experienced relationship uncertainty • Other emotions: helplessness, self-doubt, anger and distrust

8. Fathers’ Sources of Support • Most common support needs: having information and someone to talk to “…my handful of friends that I could talk to … I felt comfortable talking about it were saying ‘Oh yeah, this you know, that, we talked about it, we did this you know’ .”(DAD_01) • 4 fathers (36%) identified the need of ‘having their partner back’ “…getting my wife back to normal was probably the number one thing.” (DAD_06)

9. Fathers’ Sources of Support • 3 fathers identified exercise and having professional health services “...what helps me in a situation like that is if I can get out and get a break, go for a run, just get out and separate myself.” (DAD_05)

10. Fathers’ Support Resources • 3 fathers reported family/friends were principal sources of support. “… people just doing spot checks ‘I hear you saying your ok, I just want to come over and visit’ …”(DAD_01)

11. Barriers to Accessing Support for Partners • 11 fathers reported lack of information regarding PPD. “…somebody should be there talking about this we shouldn’t wait until it happens and then have an intervention, should be prevention…you know just talk about it at the prenatal stuff.” (DAD_01) “…I was naively thinking that everything was okay, that that was the real barrier I guess, was not having some tools or some insight to say ‘Here this is something that could be going on’.”(DAD_02).

12. Barriers to Accessing Support for Partners • 7 fathers reported stigma as a barrier “Unfortunately mental illness is still one of those things that is kept in the closet to a large degree…people say ‘oh I’d never judge people on something like that’, but hey, I’d beg to differ” (Dad-02) “I associated it with you know, Andrea Yates down in the States and that’s, the one that drowned her babies and I think that’s what people still to a certain extent associate it with and it’s not even close to the actual experience.” (Dad_07)

13. Barriers to Accessing Support for Partners • Other barriers included: • Lack of time and energy • Family denial • Caring for other children • Not wanting to burden others • Work commitments • Transportation issues • PPD not identified early enough

14. Barriers to Accessing Personal Support • Male pride (7 fathers); difficulty reaching out (4 fathers); difficulty understanding personal feelings. “I think men and women have different experiences it’s more accepting for women to share with her female friends about this stuff and men it’s not…”(Dad_01)

15. Barriers to Accessing Personal Support “I guess looking back now, I think I could have used some support. Somebody to talk to. Perhaps, like it’s a kind of a guy thing—I’m not going to really seek it out…”(Dad_03) “Well, another portion is that male stoic figure that I talked about, it’s just my arrogance and I’m a guy and I’ll take care of it.” (Dad_04)

16. Preferred Support Interventions • 6 fathers felt support should be available as soon as symptoms apparent: • 1 to 1, face to face meetings (11 fathers) • Telephone meetings (6 fathers) • Computer-based support group (1 father) • Meetings in home (8 fathers) • Meetings in community (6 fathers)

17. Preferred Support Interventions • 3 fathers wanted information on coping skills. • 2 fathers wanted information on PPD. “The most important issue...I think that from someone who has been there before to help them see that there is some light at the end of the tunnel...”(Dad_10)

18. Preferred Interventions: Group Support • 10 fathers wanted health professional facilitation. • 6 fathers wanted peer facilitation • 9 fathers wanted groups to convene in the community. • 2 fathers wanted groups to convene in home environment.

19. Families Matter-Community Based Postpartum Support Program In existence since 1981 in Calgary, Alberta On average 450 families per year Holistic model of service delivery including: -Postpartum Support line, local and toll-free -Office Support Workers (intake and follow-up) -4 support groups throughout city -Peer telephone support volunteers -Postpartum information package -Trainings, consultations and referrals

20. Couple’s Information Evenings • Held quarterly • Averages 7-10 couples • 3 hour information session about postpartum difficulties, expectations of parenthood and communication • 20-30 minute breakout session with Moms and Dads only group Demographics -Women aged 20-42, Men aged 25-55 -Professionals with mid to high income levels (both partners) -Primarily Caucasian couples attending with some South Asian and Latin American (overall clientele very ethnically diverse)

21. What Dads Say Wonderful opportunity to connect with other Dads to know they are not alone Wish they had this information before baby was born Now can understand what his wife is experiencing and support her better Facilitators are knowledgeable and they appreciate the first hand experience Time of session is too short, would like another “…I did more research on the kind of car I was going to buy then how I was going to be a parent.” “I pictured myself playing ball with my son, I didn’t think about him being this tiny person that is so dependent on us.”

22. Challenges & Opportunities • Reach more Dads, especially those from other cultures -Attend Health Region Baby Care Fairs throughout city to distribute information -Provide brochures to prenatal education classes -Website information -Translated materials • Provide support services specifically for Dads -Telephone support -Information sheet in PPD package for Dads -Couple’s Information Evenings -Referrals to other mental health professionals

23. Postpartum Support Group for Dads • Surveyed Dads who attended Couple’s sessions Results: - 4-6 weeks maximum - Evenings or Saturdays - Facilitated by a Dad and/or someone who experienced PPD • New Pilot Group starting October 22nd, 2008 -6 weeks, 6-8:30 pm in community based centre -Co-facilitated by male Registered Psychologist (specializing in Fatherhood) and female Postpartum Support Worker -both had own PPD experience -Dinner provided

24. A Service Provider/Father’s Perspective on Dealing with Paternal PPD • Views on DADS Pilot study findings. • Men’s motivations toward seeking support. • Minimizing maternal/paternal symptoms and need for seeking support. • Current paternal support programs

25. A Service Provider/Father’s Perspective on Dealing with Paternal PPD • Experience of “naming” the illness. • Listening to the experiences of other men. • Lack of information regarding PPD resources. • Fear • Outcome • Stigma • Power/empowerment once experience named and validated.

26. Thank you for your attention