Suicide is known to be the second leading cause of maternal death and NHS England recently announced it is investing £40m into new specialist treatment centres for pregnant women and new mums who experience serious psychological problems.
This announcement has been welcomed by mental health charities including CALM (the Campaign Against Living Miserably), but CALM would also like to see more services created to support new fathers, as perinatal mental health problems don’t only affect women.
According to the National Childbirth Trust (NCT) more than one in three new fathers (38%) are concerned about their mental health, and CALM’s own research shows that an equal proportion of mums and dads (3%) have considered suicide in their first year of parenthood and 47% of both mothers and fathers reported feeling suicidal, overall.
UK-wide statistics, compiled by CALM and The Huffington Post UK, reveal suicide remains the single biggest killer of British men under the age of 45.
“What we’re hearing from dads is that they feel there is a gender bias towards mums in healthcare services for parents,” said Joel Beckman, CALM general manager. “What is available is more applicable to mums than to dads.”
“From 10 years of running a helpline service for men in crisis we’ve learned that gendered services are needed and do work.
Jeremy Davies, head of communications at The Fatherhood Institute, agrees.
“With rare exceptions, UK maternity services are focused almost exclusively on the mother and baby; and little is done to challenge this,” he said.
“Governments, commissioners and inspectors of services do little to take account of the huge and growing body of international evidence showing that fathers are of great significance to children and to mothers - not to mention in and of themselves.
“Fathers are not ‘seen’ by services: too many practitioners lack training in how to engage effectively with fathers. Resources that are ‘mumsy’, full of stereotypes and exclusive of fathers continue to be distributed and re-commissioned.
“In this context, fathers’ mental health is not even on the agenda, and that needs to change.”
Fathers’ mental health is also “not on the agenda” for many new dads themselves, as Beckman explained: “We know from the research we’ve done recently with The Huffington Post UK that men feel embarrassed about opening up when they’re feeling down and that they don’t want to burden people if they feel like they’ve got a problem.
“New dads may feel that pressure even more so, because understandably there’s a lot of focus on the mum and baby at the time of childbirth, so men feel like it’s not really their place to put their hand up and say ‘I’ve got a problem here’.
“It’s really important for new dads to be aware of those dynamics and to know they’re not alone if they are struggling.
“Lots of people are going through this and there is lots of support out there.”
George Maxwell, a cognitive behavioural psychotherapist and dad-of-two from Liverpool, experienced mental health issues following the birth of his first child, Summer, in 2007.
He has chosen to speak out about his experience in the hope of encouraging other dads to feel comfortable talking about their mental health.
“New dads need support,” he explained. “They need compassion and need people to say: ‘What you’re feeling now - even suicidal thoughts, even that dark place - a lot of people have these thoughts and it’s ok. We can talk about it and work through it.’
“It’s important not to judge. Just be compassionate to both parts of that parental relationship - that’s good for everybody and can save lives and benefit children.”
Maxwell said he has never felt so “useless” and “redundant” as he did when his wife Sarah went into labour five weeks before her due date and there were some concerns for their baby’s health.
“You understand that some degree of pain is normal and appropriate for your wife, and it’s a fantastic thing that’s actually happening, but you can’t take that pain away,” explained Maxwell.
“If you’re the kind the kind of man who feels you can resolve a lot of things, for that to be minimised is certainly anxiety producing.”
According to Sarah McMullen, head of knowledge at the NCT, it really should come as “no surprise” that childbirth can trigger mental health problems in men as well as women.
“We have to recognise that the birth of a baby is a huge time of change,” she said. “It’s a massive transformation for both men and women.
“Yes, it’s different for women - men aren’t going through the birth experience as women are - but we know that mental health issues can be triggered by emotional and stressful events, and having a new family certainly is that for men.”
When Maxwell and his wife brought Summer home, he continued to feel like he was in a constant state of red alert. He’d repeatedly check on Summer as she slept, sometimes even waking her to ensure she was still breathing, and he was very vigilant if any family members or friends wanted to hold her.
“I went into this over-the-top protector mode,” he explained. “I needed to make sure everything was ok, as I feared things could go wrong and my family could be taken away from me.”
Over time the anxiety began to eat away at Maxwell’s confidence in his ability as a parent.
“I was starting to feel burnt out, tired and tetchy,” he said. “Then the negative thoughts started to creep in: ‘I can’t do this’, ‘I’m not very good at this’, and as a consequence of that, instead of allowing myself to practice and get good at handling a baby, I started to back off and isolate myself.”
Rather than seek support, Maxwell started to turn inwards, becoming withdrawn.
“You start to dwell on why you feel that way,” he said. “You start to feel tearful when you wake up in the morning and that pattern just develops over time.
“I was trying to spin a lot of different plates all on my own, while carrying a lot of this emotional burden.
“I don’t think I had full insight into what was happening at the time. I thought I could cope with it, but in reality I couldn’t.
“I was struggling. I had an emotional lump in my throat and I was holding back tears a lot of the time.”
Maxwell’s problems escalated to the point where he experienced suicidal thoughts and “the belief that my new young family would be better off without me being around.”
“But I couldn’t share this with anyone,” he added.
“Those suicidal thoughts, they’re part of depression. They pop into your mind and the very fact that you’ve having them makes you feel frightened and depressed about feeling depressed.
“But I felt there was a need to be positive, no matter how I felt, as you’ve just had a baby and of course that’s a really joyful thing. It’s a blessing, and everybody is congratulating you - they mean well, they absolutely do.”
McMullen’s experience at the NCT has taught her that Maxwell’s feeling of being unable to ask for help is common for new dads.
“We hear from many dads that they find it very difficult to talk about how they’re feeling,” she said.
“And when they’re experiencing mental health issues they don’t feel as if they can open up, as they’re worried about being judged.
“They’re worried that people think it isn’t their place to have these feelings at this time, when there is a perception that dad needs to stay strong for partner and for baby.
“Men think it may be a sign of weakness. All of this is part of the stigma that stops men talking about mental health issues.
“So we need to recognise that this is a time when actually both mums and dads need support.”
Maxwell eventually sought counselling through the occupational health service at his work and he was prescribed the antidepressant Citalopram.
“I think there’s a stigma about taking antidepressants, but for me it was helpful and it got me through that difficult period,” he said.
Maxwell also found being honest with his partner to be hugely helpful and that’s something he would advise other new dads to try, as well as seeking professional help through their GP.
“When you withdraw, you tend to assume you know what the other person is thinking and that they think you’re rubbish, but until you actually test that out by talking to your partner and allowing both people to be honest, you don’t know how they feel,” he said.
“I think it is essential that you talk to people who are closest to you.”
Maxwell’s experience has taught him that with the right support his mental health problems were surmountable - so much so, that the birth of his second child was a very different experience.
“Leading up to birth there was apprehension and the usual anxieties,” he said. “But actually I was looking forward to it, as I did feel more resilient because of the bond I’d developed with Summer and the way I’d overcome things.
“To other new dads I would say: There are going to be very few events like this in your life, so it’s important to acknowledge that actually this is a huge transition.
“Be compassionate. Be kind to yourself. Speak to the people that are around you, speak to your GP. See if there are therapies or other kinds of ways of actually supporting you through this period in your life.
“You don’t need to sit on this. It’s ok to feel the way that you do, but don’t keep it to yourself.”
McMullen advises that there is lots dads can do to think about their own mental wellbeing.
“One of the things we always say to new parents is to take all offers of help and not think that you have to do it all by yourself,” she said.
“Recognise that yes, you have a baby to look after, but it’s just as important to look after yourself and your partner, so try to find that little bit of time where each of you can take some time out get some fresh air, exercise and eat well.
“But it’s really important to realise that even if they do all of that, people can still feel quite low, and if they’re worried about having mental illness it’s very important to talk to somebody, because it may be that you need specialist support and the earlier you access that support, the quicker you’re on the road to recovery.”
Lucy Lyus, information manager at Mind, advises: “Speak to your doctor about your mental health. They can refer you to local support services, talking treatments and prescribe you medication if required.
“Make time to look after yourself. Mind’s website is a great resource, particularly the page on self-care with lots of ideas on how to look after your mental health when becoming a parent.”
Beckman adds that there is also support available that is tailored to men.
“Also, from my own personal experience, NCT groups aren’t only great for mums. Men should know that other new dads they’ve met at NCT groups, can be a great source of support.
“Finally, the role that friends, peers and colleagues have to play is crucial.
“Becoming a father is such a massive time of change and by reaching out to friends and just checking in with them to see if they’re ok, that also gives the new dad permission to be able to talk if he is feeling down - and that potentially could make a massive difference to somebody’s life.”