Screening Fathers for Postpartum Depression: What Does the Research Say?

This case study evaluates a program to screen fathers for postpartum depression in a maternal-child health clinic in a midwest urban academic medical center. The study found that the program was effective in identifying fathers with postpartum depression and that those who participated in the program were more likely to receive treatment.

DR T S DIDWAL ,MD

10/9/20233 min read

Screening Fathers for Postpartum Depression: What Does the Research Say?

In the realm of postpartum depression (PPD), we often hear about its profound impact on mothers. However, a critical aspect that has garnered relatively less attention is its impact on fathers. Recent studies estimate that between 8% and 13% of fathers experience PPD, making it a significant concern. Paternal PPD not only affects the fathers themselves but also has far-reaching consequences for the overall quality of family life, the physical and mental health of all family members, and the developmental and relational well-being of the father-mother-child triad.

The Silent Struggle: Paternal PPD

While the significance of paternal PPD cannot be overstated, there is a notable absence of clear recommendations or established protocols for screening fathers for this condition. To address this gap, a groundbreaking program was initiated to pilot paternal PPD screening in an intergenerational postpartum primary care clinic.

Program Implementation and Key Findings

The pilot program took place at a Midwest urban academic safety net health system from October 2021 to July 2022. Fathers who were actively involved in relationships with mothers or infants receiving primary care in the clinic were approached with mothers' permission. The program utilized a novel survey instrument to gather crucial demographic and social data, as well as mental health history and current stress levels. Additionally, the Edinburgh Postnatal Depression Scale (EPDS) was administered to assess the fathers' mental well-being. Trained social workers conducted the screenings, and data were meticulously collected in REDCap, with subsequent descriptive statistics calculated in SAS.

Unveiling the Unseen Struggles

The results of this pioneering program shed light on the often-overlooked challenges faced by fathers during the peripartum period. Among the 29 fathers contacted, a remarkable 83% agreed to participate in the screening. The average age of the participants was 31 years, with a broad age range spanning from 19 to 48. An astonishing 87% of the fathers identified as belonging to racial or ethnic minority groups.

Hidden Battles and Potential Solutions

Interestingly, fathers self-reported low rates of stress and preexisting mental health conditions. However, what is particularly concerning is that 30% of the screened fathers tested positive for PPD based on their EPDS scores (scoring ≥ 8) or exhibited suicidal ideation. This striking revelation underscores the urgency of addressing paternal PPD and the need for comprehensive healthcare support.

Bridging the Healthcare Gap

Furthermore, the findings exposed significant gaps in healthcare access. Shockingly, one-quarter (26%) of the fathers screened were uninsured, and a staggering half (54%) did not have a primary care provider. This deficiency in healthcare access for fathers is a critical concern that must be addressed promptly.

A Beacon of Hope: The Impact of Screening

The impact of the paternal PPD screening program goes beyond just identifying individuals in need. Following the screening, two fathers requested mental health services, and three established new primary care relationships with physicians. This not only highlights the program's effectiveness but also serves as a testament to its potential to catalyze fathers' engagement with general healthcare.

Towards Holistic Family Well-being

In summary, this pilot program's high participation rate and the significant peripartum mental health challenges identified in fathers underscore the necessity of expanding paternal PPD screening into routine primary care settings. This proactive approach is a crucial step towards not only supporting the mental health of fathers but also enhancing the overall well-being of families. The integration of paternal mental health into the broader framework of family health is imperative for a healthier and happier future for all.

Reference Article

Sam Wainwright, Rachel Caskey, Aida Rodriguez, Abigail Holicky, Melissa Wagner-Schuman, Anne Elizabeth Glassgow. Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center. BMC Pregnancy and Childbirth, 2023; 23 (1) DOI: 10.1186/s12884-023-05966-y