Managing the self and other relationships: a father’s role when his partner and baby are hospitalised in a perinatal mental health unit

Abstract

Objective To examine the father’s role when his partner and child are admitted to a perinatal mental health unit. Background Establishing attachment in the first months of life is crucial for infant mental health. Parental mental health and separation can interrupt the formation of attachment. Maternal postnatal mental health is known to affect the father’s well-being and mental health. A systematic review conducted found paternal depression in the first year after birth affects child behavioural and emotional difficulties. One previous study has gathered limited evidence of fathers experiences of a perinatal mental health unit. Method Eight interviews were conducted with fathers whose partner was a current or former inpatient in a perinatal psychiatric unit in Scotland. Grounded Theory was utilised in the collection and analysis of data. No participants reported symptoms of Depression, Anxiety, or Stress at time of interview. Transcripts were coded by the researcher and supervisors and categories were compared. Additionally, results were validated by a participant before completing analysis. Results Maternal postnatal mental illness and hospitalisation was challenging. Long admissions with infrequent visits were most difficult. The overarching category ‘managing the self and other relationships’ captured the father’s experience and how he tried to understand and manage, whilst making and maintaining family bonds. Five subcategories were Bonding with Baby, Keeping the Family Together, Feeling Contained, Feeling Overwhelmed, and Experiencing Uncertainty. Fathers had concerns about bonding and regarded the mother-baby bond as vital. Relationships were strained. Fathers experienced anxiety regarding illness and felt relief on admission. Fathers experienced demands such as work and travel. They tried to retain normality, take each day as it comes, and use family support to cope. Fathers were uncertain about illness and treatment and desired improved communication with professionals. Conclusion Severe maternal postnatal mental illness and inpatient admission affects fathers. Fathers have multiple demands which impact on participation in the unit. Fatherinfant bonding was affected by father availability. Recognition of the father’s experience and increasing father’s knowledge of illness and skills in caregiving is likely to improve the father’s experience and benefit the family.