Audio transcript (edited)

DAN MOSS: Hello, everybody. My name’s Dan Moss and welcome to today’s webinar, Supporting Father’s Mental Health during the Perinatal Period. This is one of a series of webinars which you may have seen before. It’s a joint partnership between CFCA and Emerging Minds. Before I begin today, I’d just like to acknowledge the country that we all meet on today, just like to acknowledge that I’m sitting here today on [Kaurna] 00:00:34 lands and pay my respects, as I’m sure you do pay your respects for elders past, present and emerging, as well as to any Aboriginal and Torres Strait Islander people who are joining us today. At Emerging Minds we’d really also like just to acknowledge the contribution that Aboriginal fathers have made to our work and particularly in our recent rebuilding [unclear] 00:01:03. That’s a documentary which is part of the resources which we’ll provide a link for you later on and today. That was just a lovely depiction of some of the values and the commitments that Aboriginal men have for being fathers.

So, today we’re obviously just [audio glitch] 00:01:30 men’s mental health as fathers during the perinatal period that is often described or discussed on this issue. Today we won’t be going so far into the issues of working with fathers who use violence or screening for domestic and family violence, or into infant, health and wellbeing, although we understand that those three topics are topics of enormous interest and ones that we just feel need their own specific time slot to really dive into deeply. We just also want to say that we recognise that the research and knowledge in this space is mainly on white heterosexual or cisgender men. We would like to acknowledge that families come in all sorts of shapes and sizes. It’s important that diversity is considered when working with fathers and families.

We also have some resources on inclusive practice with rainbow families, which can be found in the webinar’s resources as I discussed, at the end of this webinar. So, before any further ado, I would love to introduce you to our fantastic panellists today. First up we have Carol Dabb who is currently doing some amazing research for her PhD and she’s focusing on men’s mental health during the pregnancy period. Lovely to have you here today, Carol. Welcome.

CAROL DABB: Thank you, Dan. Good to be here.

DAN MOSS: Next up we have Kirsty Lowe, who’s a lecturer at Flinders University. Kirsty has over 20 years’ experience working in the infant mental health space. Welcome, Kirsty.

KIRSTY LOEW: Thanks, Dan.

DAN MOSS: Our third panellist today is a new father, or a newish father, Claudius. Claudius is a child and family partner at Emerging Minds and we know Claudius really well because he’s contributed a lot to our e-learning courses and also to podcasts and filmed interviews. It's lovely to have you here today, Claudius, to share some of your personal experiences.

CLAUDIUS REIMAN: Thank you. It’s a please to be here. Hello, everyone.

KIRSTY LOEW: Hi, Claudius.

DAN MOSS: Okay. So, we’re going to start off by just asking our panellists some questions about their particular research or practice or lived experience. Carol, I’m going to start with you because I’m really fascinated by your research in this area of men’s mental health during the perinatal period. Can you tell us a little bit about some of father’s experiences throughout this period?

CAROL DABB: Yeah, absolutely. So, it’s a period of big transition and change for fathers and part of the transitional experience of this perinatal period is that men are likely to experience quite a range of concerns and worries, and this is actually developmentally appropriate, but in some cases, fathers are not able to control the frequency or the extent of their worries and concerns, and this can actually feed into the development of anxiety symptoms which are strongly linked to the development of depression as well.

So, the perinatal period, even though fathers go into it thinking it’s going to be all fun and exciting, they actually might experience issues with their mental health. So, research shows that about 10% of fathers experience depression during pregnancy and then after the birth. That can even increase after three to six months. So, three to six months after the birth, 25% of fathers may experience depression at that time. Then in terms of anxiety, 25% of fathers have been reported to experience anxiety symptoms during pregnancy, which drops down to about 18% after the birth. Then some men are experiencing post-natal depression. About 5% of men experience some post-traumatic disorder after they witness a traumatic childbirth of their child.

So, in terms of the bigger picture, men are experiencing difficulties in different ways and their concerns can feed into that. So, during pregnancy particularly, men might worry about the health of their baby, their partner’s health, whether or not their partner is receiving adequate health care, whether or not they themselves as fathers are adequately supporting their pregnant partner, whether they have what it takes to be great parents, the responsibility that comes with parenthood, the change of lifestyle.

So, there’s a lot. They’re thinking about a lot, they’re weighing up a lot and often they don’t voice these concerns because they don’t want to take care away from their partners or add to the concerns of their partners, or they feel that actually, it's a sign of weakness to have these concerns and what man feels this way during pregnancy or after pregnancy. So, they don't speak up. So, yeah, that's why this topic really important.

DAN MOSS: Great. Thanks for that, Carol. Kirsty, lots of men, and Carol touched on this, are really trying to find ways to connect with their newborn baby and their partner at the earliest possible stage. But I suppose there are also still some barriers that can occur for fathers within systems to allow them to do that. I’m wondering given your experience in the field, whether you could describe some of those barriers?

KIRSTY LOEW: Sure, Dan. I think practitioners are becoming increasingly aware of some of that research that Carol was talking about and the importance to engage Dad. I guess the numbers of people that are here today are testament to that. But certainly, it’s more complex than just whether dads, what’s happening for them and whether they could access support. The services I don’t think have caught up to how to address the needs or dads, so things like when and where services are provided is still a barrier. So, services are generally provided still during business hours when a lot of dads would be working. There’s not that flexibility around access.

There can also be things like probably service design is still focussed around women-centric services and so, there's not additional resources put into it, like it's quite different to work with a family unit versus a single caregiver and the child. So, things like additional time for visits or the work that you're doing. I know in my experience, if a dad was present and I was working with him and the mother, it's two lots of screening tools, additional documentation, those sorts of things. I don't think the service design systems have caught up. There can also be, like I said, where services are established around working with women, even the way we record information, does it really equip us to be able to capture the work that we're doing and the issues for Dad?

So, our data systems we set up around a single primary caregiver so then what do we do with the information after we've met with a dad, how does it get recorded, how do you maintain the confidentiality and privacy? Those sorts of things. So, I think absolutely practitioner awareness is growing, but there are still how do we actually tackle this in a way that we can provide the best service to dads and families.

DAN MOSS: Thanks, Kirsty. Claudius, so you’ve not that long ago gone through these experiences yourself and we know you as a very engaged father and have really wanted to be as engaged as possible right from the get-go. I’m wondering whether we could start by asking you a little bit about your experiences or reflections as a first-time parent?

CLAUDIUS REIMAN: Of course. For sure. First I have to say, Carol and Kirsty, I completely agree with pretty much everything that you said. My experiences when my wife got pregnant, I like to be a giving person and any concerns or things that I had during my wife’s pregnancy, for myself, needs for myself, I kind of pushed to the back of my activities while I focussed on my wife. All the concerns that you listed, Carol, I felt those at various stages. Is my wife okay? Is the baby okay? How do I go about being a supportive father? What kind of a father am I going to be? How do I be the best? I perhaps overthought some of it. But it does compound and unfortunately, there was no one to say that if you overthink this too much it's going to come to a head later on.

I found that after my son was born, that mixed in with the fatigue in our early weeks, the fatigue brought on enormous feelings of depression and guilt. I wish that somebody had said, “Fatigue can do this to you. You need to be aware of it.” It wasn’t until I actually went to my GP and I said to my GP, “I have all of these intense feelings. What is the cause of it?” It wasn’t until he explained to me, “It’s okay, you’re doing everything right, this is just fatigue that’s causing this.”

Kirsty, I completely understand where you’re coming from in terms of the additional workload, including the father in these visits and the documentation associated with it. I can vouch for the fact that a lot of the times when my wife was receiving appointments with medical practitioners during the pregnancy, I may have been present but I wasn’t really considered, if that helps support what you have available to you. I was more of an incidental. Dare I say, someone to help my wife in and out of the room, you might say. But nobody really considered what kind of an impact this life-changing event would have on me as an individual and my thought processes. I absolutely get what you've been talking about. That’s my take, that’s my observation from my experiences in this.

DAN MOSS: Claudius, can I just ask you one more question?

CLAUDIUS REIMAN: Yes.

DAN MOSS: You mentioned that before a GP had gave you some advice, it sounds like he might have been someone who was able to take your individual needs as a father into -

CLAUDIUS REIMAN: Oh, yeah.

DAN MOSS: - kind of mind. What was it about him do you think that allowed that to happen?

CAROL DABB: The GP that we were seeing at the time, he's a very blunt man. He sees the issue and he can see everything in front of it and it's straightforward. But not in a harsh way. If you're obviously in discomfort, he addresses the issue and highlights the positive aspects of your work and explains that the way that you're feeling it is not accurate. He has a gentle way of directing you to the correct conclusions. To not put too fine a point on it, what I had originally been feeling as a result of the fatigue was intense guilt that I had contributed to bringing my son into the world. This is a hard world. You can’t dress is any other way. You have to work hard here. I felt terrible that I brought my son into this world where he will eventually have to work hard.

I'm a bit of a soft individual and it came to a head one morning when I went into the bedroom after having the night shift looking after him, I knelt down by the bed next to my wife and I was like, "What have I done? What have I done?" It was at that point that we both decided we need to go to our GP and we need to discuss this because this is extremely intense and perhaps disproportionate to the reality of the situation. Yes. No, when I saw my GP he listened and he reassured me in a calm, gentle voice. He didn't disregard what I was saying. He was like, "I hear what you're saying. I can understand how you are feeling. But it is not the case. You are doing everything correctly and what you are feeling is a result of your fatigue and that fatigue is feeding depression.” Surprisingly enough, that’s really all I needed to hear. As soon as I heard that, I understood this was being caused by that and with that understanding, I was more mentally equipped to deal with it, despite the fatigue that I felt.

DAN MOSS: Thank you, Claudius. That’s a really lovely insight. Thank you. Kirsty, I want to ask you now, sometimes practitioners who work mainly with mothers or with women, might talk about some hesitancy in working with men or fathers, and might perhaps have worked with men or fathers in the past who have been difficult to engage or they might have had an experience where a man perhaps has demonstrated [a bit of contempt] 00:17:41 towards his partner. Can you tell me a little bit about what are some of the ways that you as a practitioner found to overcome hesitancy or ambivalence and how this might be useful for other practitioners?

KIRSTY LOEW: Sure, Dan. I think there can be a lot going on for practitioners in this space and absolutely, a lot of people have got their own experiences of working with men where there maybe has been some challenging behaviour. We also are the result of beliefs in society that parenting might be more women’s business, those sorts of things. So, we take that with us. I think there’s also it can be a hesitation around our own discomfort in these situations, and I guess while we need to be really, really mindful of worker safety and the safety of women and children in these situations, I guess it's like how do you balance that, how do you maintain that focus on absolutely we need to do risk assessment and be very aware of the risks, but also not let that be a barrier to our engagement?

I think one concept that I found really helpful and not just in working with dads, but of course, other situations as well, is the idea of ports of entry, that there are a number of different ways that we can enter working with somebody and it's about finding that right avenue. I think for some of the dads I've worked with that port has been not through taking head-on, I guess challenging head-on maybe some of those behaviours, but using their wishes, their hopes, their dreams for the way they want to parent or their relationship with their child as then the avenue to access and work with those dads to build that relationship to maintain some compassion for them and I guess maybe maintain some hope that things can be a bit different for them and the way they parent or how they’re going.

So, I think that’s been particularly helpful, is thinking about that and we might not need to stay there the whole time, that might be at least the point that we can start having some of these conversations. For example, if a dad’s the father of a daughter, how can you start then lifting up what some of his behaviours might mean for that experience and what he hopes for his daughter’s experience in life to be? Those sorts of things. Yeah, I think sometimes in my experience, despite the discomfort, despite the hesitancy, it was really important to name some of my concerns or some of those challenges.

I guess there's one family, in particular, I can think of where they were some of the most exhausting conversations I've had, but it was really important because I could see when the dad was in the room the important role he played in that little person’s life, that he was the more consistent parent and the safe parent for her, and so how important it was to have him present. That was really, really critical.So, at times we did have to agree to disagree. Some of his views around discipline or the way you parent or the impact of his own and his partner’s mental health on the baby, we saw things differently. But we still had those conversations where I still lifted up and said that this is what my experience tells me. So, that may have been the first time that either of those parents had heard some of that information. Some of it’s developmental information, those sorts of things. But I think I wouldn’t be doing my job if I didn’t raise those concerns or give that information.

DAN MOSS: I just want to ask you, Kirsty, what difference as you’ve gone along and become really committed to asking fathers about their hopes and their wishes and their dreams, what difference do you think that’s made for them in their engagements with you?

KIRSTY LOEW: I think it feels like a more genuine engagement for them, that I'm not just there in the service of working with their partner, that I am there to listen. I genuinely and authentically want to hear their experiences and their stories. So, sometimes they have opened up about their own experiences of growing up, what it felt like for them, those sorts of things, and being able to share that. Of course, that makes sense then about some of their ideas around how you parent or what you do with your mental health, those sorts of things.

DAN MOSS: I suppose also, so many men start to develop a sense of commitment to their own children because they want to be different to -

KIRSTY LOEW: Absolutely.

DAN MOSS: - how that might have been with their own dads or stepfathers. Yeah.

KIRSTY LOEW: Sometimes the first reaction is, “Well, I was brought up this way and I’m okay.” But sometimes if you can kind of stick with it and see that through, you do start to hear where actually they want something different. That goes for a lot of mums too. You’ll hear that story a lot from a lot of mums. So, for both parents. Often, it’s the, “But I don’t know what to do differently. This is all I know.”

DAN MOSS: Yeah, thanks, Kirsty. Carol, a lot of what your research currently is thinking about the importance of investing in healthy fathers and father’s mental health because that means that they’re unable to support partners and babies much better. Can you tell us a little bit about what you found in that area?

CAROL DABB: Oh, absolutely. Yeah. I mean, the research on this is so overwhelmingly clear that it motivates me and should motivate others to support fathers during this period. So, for instance, if a man’s doing poorly in his mental health, there are strong links to his partner also doing poorly in her mental health, and then that obviously has negative outcomes for her and for her infant during the perinatal period. So, there’s that link between the couple and how they’re both doing in terms of their mental health.

Then there’s the link of if a husband or a partner is able to give good support to his pregnant partner, that’s actually linked to really good outcomes. So, women who receive good partner support during pregnancy have lower rates of depression during pregnancy and after childbirth. Better health outcomes also, so for instance women who don’t receive good partner support are more likely to experience a pre-term birth, more likely to experience their baby being born at low birth weight or having a low Apgar score. So, real ramifications there for support.

Then if we think beyond the support that father provide their partners, there’s also the impact of fathers on their children, which Kirsty really touched on in such a lovely way. The research shows that men with post-natal depression are less likely to engage in positive father-child interactions such as play or reading with their infants. They are more likely to be a bit less responsive to their infants, their children exhibit outcomes. So, for instance, children of fathers who have experienced post-natal depression have a higher rate of negative reactivity as an infant and then they may develop emotional and behavioural problems as toddlers. Right up until seven years of age, there's been research to show that these children may develop psychological and social difficulties.

So, the mental health of fathers is important not just for themselves and their partners, but also really important for their children’s outcomes. Really, we do need to talk about the men themselves. If they’re doing poorly with their mental health, they’re more likely to experience persistent fatigue after the birth, they’re more likely to experience parenting as a stressful experience. They’re less confident in their ability to parent and many of them experience sleeping difficulties. So, when you think about all these different connective outcomes and how supporting men really would support not just themselves, but the whole family unit. It’s a pretty critical time really for men.

DAN MOSS: Thanks, Carol. Claudius, for you and you touched on this in your last answer, why is it crucial do you think for practitioners to be not just considering one parent or the other, to be thinking about a family unit, however that looks, and to be assessing the individual needs of every parent or each parent that comes to a service?

CLAUDIUS REIMAN: I think the answer is reasonably simple, Dan, that when you think about a family unit like the mother or the father, whether a wife or partner, it is a joint partnership. You almost never hear about any circumstance whether it’s a partnership where only one individual does all of the work. A child in a mother and father environment, is exposed to both. I think if the mother and the father have access to medical mental health care, or anything else like that, it is important to include both and consider them not as individuals but as a whole, so that at the end of the day information is clear and complete and transparent and there’s no ambiguity, if that’s a reasonable word to use, with the information that is given so that both parties understand the situation completely and clearly no matter what side you’re on.

I think that leads to a more solid and supportive understanding in the family unit, if that’s a fair thing to say. I mean, that’s my perspective. Yeah, that’s my perspective on it.

DAN MOSS: Absolutely and a very interesting and insightful perspective. So, thank you, Claudius. I’m not going to move on. We’re going to talk a little bit now about – I’m just going to talk about some practice tips or practical advice. Because I think what we’ve covered is that it is important that this is a really important part of work in the perinatal infant mental and parental mental health space. Carol, I might start with you. Given what your research does show and you’ve talked about this so unequivocally the importance of engaging with men, what does the research also say about what works to support fathers?

CAROL DABB: Yeah, so there’s obviously a lot more to be done in this space. Firstly, the leading researchers around the world are recommending that fathers are routinely screened for mental health difficulties during the prenatal as well as the postnatal period. So, preferably in conjunction with their partners. That’s really important, but as yet, there aren’t any specifically designed screening tools that have been developed for use in men during the perinatal period when they experience quite unique concerns and issues. So, at the moment, in terms of recommendations that are out there, men are being screened using the Edinburgh Postnatal Depression Scale. But it’s recommended that a lower cut score be used in men’s. So, a score of around six which is lower than the score used for women.

Clinicians need to be mindful that low mood in men is sometimes exhibited in symptoms that are not picked up by the Edinburgh Postnatal Depression Scale. So, for instance, anger or irritation, they’re things that practitioners need to kind of be tuning into as a gauge of how men are coping during that period. Then in terms of anxiety, the screeners that are currently being recommended are the general anxiety screeners like the DASS 21, which are good screeners, but they can miss men who are specifically struggling with pregnancy-related anxiety, which is a sub-type of anxiety in which they do worry about all the aspects of pregnancy and the transition.

So, in conjunction with a general anxiety scale, it’s good practice for having open dialogue with fathers about whether they’re experiencing any concerns, what they might be, how frequently are they experiencing these concerns and whether their worries are starting to interfere with their sleep or becoming difficult to control. Because those are signs that men are not really at that adaptive level of worry where they’re planning for the future, but they’re starting to really have this cyclical worry that’s feeding into potentially the development of anxiety. So, just to be mindful of that.

Then in terms of supporting fathers, the literature emphasises the importance of being proactive and asking fathers about themselves, rather than waiting for fathers to seek help themselves. If therapy is needed, we’re still using CBT and interpersonal therapy as the main approaches that seem to work well during this period. There is the SMS4dads text messaging support service which has a huge amount of research behind it, very accessible to fathers and a way for men to normalise some of their experiences and get some help around that.

Yeah, there’s research being done in terms of providing them with specific like psychoeducational sessions, support-type sessions. But what the research shows is that those types of sessions are better done if they're presented to men within the context of already attending a couple's antenatal type service or classes. If they are advertised to fathers, they should be advertised as practical skills building, not as a come along and talk about your thoughts and feelings because we’re worried about you. Men aren’t likely to respond to that. So, yeah, also having one-off sessions for men, rather than making them sign up to a six-session program. So, that’s pretty much all I can say on the research end.

DAN MOSS: Great. Thank you, Carol. There’s a lot of information there. Thank you, that’s really comprehensive. What about for you, Kirsty in your practice, what are some of the techniques or the tools or the considerations that you’ve used to be able to engage men more fully throughout the pregnancy or early years of a child’s life?

KIRSTY LOEW: Yeah, sure, Dan. I guess building on from what Carol was saying, I mean we did use a number of screening tools in the work that we did. The one’s that she mentioned like the DASS 21, those sorts of things. I guess for me it was important to think about the purpose of those screening tools and not seeing them as a replacement for the conversations I needed to be having with the dads, or with any of the parents really. Sometimes they were really helpful to open up conversations. Maybe naming some of the taboo areas or being able to wonder about what might be happening for someone, we given a certain score, those sorts of things. But it was also important to think about what do you do next, how do you support a dad to then access the actual supporting needs around what screening tools shown? Is that something that I can provide those sorts of things? Absolutely had a place, really helpful as a piece of information but then still needing to think about well what do you do next.

I think one thing that we did was sometimes the support we provided to fathers was not direct, it was almost through the work I was doing with mothers. So it was almost like even though dads weren’t in the room, we were still needing to lift up their experience. Some of that was just through wondering about the dad’s experience, wondering about what’s happening for the dad. A mum often might have expressed concerns about changes in behaviour that she’d noticed, the irritability, reluctancy to be involved with the care of the infant, some of those sorts of things. So, I guess it would be some education and information for her that she could either – to help her out, but also to take back and share. Sometimes in the work that I did, I also worked with supporting other practitioners and that was really helpful to I guess just take that, again that wondering position off.

Sometimes other practitioners would come to a really definite position about what a dad’s behaviour meant and it might be about joining with a mum in saying, or he’s being, I don’t know, a bit of a jerk in this moment, for lack of a better word. But sometimes it would be if you can wonder about what else might be explaining that behaviour. What might be happening for dad? I mean, there was one instance where I think the infant had a chronic health issue and dad was a nurse. His profession was a nurse, so there was this expectation that dad would be the one that would administer the treatment and the therapies and things like that to the child. There was a real resentment towards the dad when he wasn’t able to do that. So, it was like, well it was almost these assumptions of well he just should do that.

So, when we stepped back from it, has anyone asked dad how he’s going? What is it like to actually be expected to be the nurse to your own child? What’s it like for him to have a child with a chronic health issue? Some of those things. It just allowed us I guess a different perspective, different avenues too, to do some work. In terms of when dads are in the room, I think some of the most basic approaches are the same things we’d do with anybody. Being genuine, being authentic. But really specifically and explicitly inviting him into the conversations, asking specifically about his experience. Because I think sometimes dads are a bit lost about am I meant to be in this, am I not meant to be involved, what do I do?

Then I guess also, warming up to questions maybe about his emotional well-being and enquiring about that. So, maybe using something like sleep deprivation as a way to begin having those conversations rather than going straight for the emotions and the feelings, which might then be more off-putting and uncomfortable. So, that’s some of things that I used. Yeah.

DAN MOSS: Thanks, Kirsty. So, Claudius, for you as a new father, so you may have been asked some of these questions or gone through some of these assessments which Kirsty and Carol have talked about. What questions or engagement strategies worked for you or if they weren't employed with you, what would have you liked to have been asked as a new father?

CLAUDIUS REIMAN: First I have to say, Carol, Kirsty, if I had known about any of those strategies I think they would have helped a lot. Unfortunately, to the best of my recollection, which is pretty reasonable at best, I can’t recall ever experiencing them. The times that I did go with my wife to her medical visits, I literally was sitting in a chair just listening to the general practitioner speaking to my wife about how things were going. I don’t think once they asked me how I was going, “What’s your take on this? Do you have any concerns or anything else?” No, it was all directed at my wife, not that I’m complaining about that because she was carrying the baby. She was carrying Christopher. But at the same time, I was putting a lot of effort in. I felt like I was putting a lot of effort in. I was looking after her, I was concerned for her, I was concerned for her health, I was concerned for Christopher's health.

No, not to the best of my recollection do I recall ever being screened or asked how’s my sleep going or am I fatigued or any feelings of depression. No, I don’t recall that I ever was asked any of these. Which is surprising, that you actually mentioned that they exist. I wish that somebody had, I do wish that somebody had asked. Because I would have said that there are times that I’m exhausted, but I keep going. That I’d like to know whether or not I’m doing this correctly. But a lot of it was intuition on my part. It was like my wife is pregnant, she’s tired, she’s carrying around my little boy, but I don’t want her to have to do the work or to think that she has to do the work. She’s already doing half the work, at the very least I can pick it up. That’s what I felt that I went through, the whole nine months that she was pregnant.

CAROL DABB: Claudius, when I hear you talking like this, it’s like the very papers that I read in my study coming alive with your voice. Your experiences are not the exception. They seem to be very common for men. They’re never asked how they’re going in terms of their sleep, their mental health, their coping, their concerns. It’s quite sad. But there are ways to help men, but they’re often overlooked.

CLAUDIUS REIMAN: I would like to say though, - sorry. I just wanted to say that despite what I’m just saying there, I’m not saying that the practitioners that we went and saw were not doing their job. They were doing a wonderful job. But I think that there were aspects of development that were potentially neglected or they were not aware to pursue. I’m happy for the work that the practitioners did, but I feel that there were other areas that they could have taken into consideration had they had the tools at their disposal and that they were aware to use them.

KIRSTY LOEW: I was just going to say from a practitioner's perspective, I wonder whether some of it is that lack of awareness or those assumptions that get made, that the experience is different for dads and it's not significant. That they're not going through the physical changes of carrying the baby. So, it’s almost not through a not wanting to include dads, but it’s just kind of out of mind. Because I guess the knowledge hasn’t been there until this point about just how difficult the transition is for men as well, those sorts of things. Not to say we shouldn’t do better, but I wonder if there’s some of that going on.

CLAUDIUS REIMAN: Possibly. I know that when I visited the practitioners with my wife, that I tried to present shall we say a strong and supportive individual as I possibly could be. A lot of the time I feel most likely to my own detriment, that I masked the things that were weighing on me. As I said before, I put them to the back.

DAN MOSS: Thanks, Claudius, and thanks everyone for their answers. We’ve got some live questions and answers coming through from you the audience, which is fantastic. Thank you and keep them coming, we’ll try to get through as many of those we can in the next little while. One of the questions that’s coming through is how do we prepare men, how do we prepare men, particularly who haven't been fathers before, and help them in that period to adjust to fatherhood? Carol, I might start with you, with that one. What does the research say in terms of what we can do to actually help men to feel as much as possible kind of in a solid position to be getting their head around some of the new challenges?

CAROL DABB: Part of it is normalising their experiences. So, men struggle more when they feel like they’re not receiving enough support. Part of support is being able to say to someone, “Look, this can be a tough time and if you are having difficulties it doesn’t reflect on you, in terms of your strength as a human being. It’s common what people struggle.” Sometimes advertisements on TV or Father’s Day, makes it look like parenthood is this wonderful – you’re at the playground, pushing your child on the swings all day and it’s just so exciting and wonderful all the time. Maybe during the antenatal, pre-natal period, it might be worth for people to kind of normalise the fact that it’s also got its rough times.

I don't know, just normalising it for men. Because one of the things that comes through in the research is that they felt very alone in their experiences. So, they might have experienced anxiety or depression, but they thought they were the only ones. They didn’t appreciate that this is a legitimate experience and they’re not the only ones. Others have made it through and they can also.

DAN MOSS: Just while you’re answering that, Carol, another couple of questions that are coming through our audience, really kind of asking you what the research might say about men who still have an expectation that they work really hard for long hours and continue to do that while they’re parenting in the early years. What might be some of the implications or effects of that?

CAROL DABB: That’s actually another source of stress for these men. Juggling work commitments with family commitments, it can actually feed into feelings of low mood and not being able to meet expectations in both parts of their lives. A lot of them feel the financial responsibility to care for their entire family and then plus the work demands and then the family demands. It’s actually one of the significant stresses for men. It’s a tricky one because by doing well in their workplace is they’re supporting their families, but at the same time they sometimes get this conflicting message that they’re not doing enough. It’s actually really difficult for them to find that balance.

DAN MOSS: Thank you, Carol. Yeah, great answer. Kirsty a question for you, that we’ve got. In your experience, how can practitioners support men who have existing mental health issues that they may already be seeking support about? Our concern that being a new father might actually exacerbate those mental health concerns.

KIRSTY LOEW: I guess part of it is having open conversations with dads. Enquiring about their experience, thinking about maybe things about what would be the warning signs that you’re not coping as well as you had been. Even I guess plans around what do you, how do we manage this if you’re noticing changes. Because there might be through some additional stresses, all those sorts of things that it might be an exacerbation. I guess it’s also being realistic with them about how do they make that adjustment and manage their mental health with the additional demands that they’ve got when they might be up helping with settling a baby overnight and those sorts of things.

So, I guess building partnerships with the other people that are supporting them, whether it’s the GP or a psychologist or those sorts of things, and being collaborative and having open conversations around how can we wrap support around this person to make sure that they’re equipped that, that they’ve got information and we provide them with some strategies to manage when they need it.

CLAUDIUS REIMAN: Claudius, a question for you from the audience. So, Kirsty talked about talking to men or new fathers about their hopes goals, their dreams for their children. How important do you think that is? When you knew that you were going to be a first-time dad, was this something that was a really important thought for you about what you wanted for your newborn child? And what would it have been like to have someone ask you about that, within a service system?

CLAUDIUS REIMAN: That is a very weighty question for me, because as you can imagine you always want the best for your children. Always. There is no point in your life where you’re like, oh, they’ll figure something out. You want to invest your heart into providing the most secure path for them in life, to the point where they can make their own decisions. That often takes up a lot of your mental capacity. Are you keeping them healthy, are you laying the framework in the future, and that starts early, it starts very early. And the things you have to consider is health, physical and mental. Financial health. Where are they going to go later when they study? How well do they interact socially? Is there anything that you can do to help? I never got asked any of this when he was born. I think maybe there’s an assumption that’s for someone else to work out. I can tell you that it does weigh, it weighs very heavily in my mind, on a daily basis. I push to try and lay the foundations for something that will benefit him later in life.

DAN MOSS: Not asking you to talk for other men of course, but how do you think that is for all fathers to be thinking about what they hope for, for their child? Whether that’s a different childhood from the one that they experienced or similarities or something completely different. How important is it to people in planning for that as a dad?

CLAUDIUS REIMAN: I feel for myself that it is very important because when your child grows up and they achieve that completion of what they want to do, there should be an incredible amount of pride in a father in the knowledge that they contributed to this and they helped their child succeed. When you think about it, if you are emotionally and physically bound to somebody in a way that a father is to their child, almost nothing can give you greater happiness and contentment knowing that everything that you did to help your child become who they want to be later in life, that could be one of your single greatest achievements throughout your entire life.

When you think, if you live to be 80 or 90 years old and you helped your child become the greatest that they could be, that’s a heart-warming, a sobering experience. That's how I feel about it and I would like to think that there are many men out there who are first-time fathers and they feel the same. Whether they voice it or not, it is something that they aspire to and they fight on a daily basis their circumstances to try and lay their own foundations to make this happen and sometimes it’s a silent fight.

DAN MOSS: Thank you, Claudius. Time for one quick more question from the audience. This is for you, Carol. Does the evidence show that dads today are more committed to spending genuine time, a bit like Claudius has said with their newborn babies, throughout their childhood that they have been in previous generations?

CAROL DABB: Yeah. Definitely, they are wanting to be more involved from the get-go. They want to be more involved during pregnancy, but definitely once the baby is born and involvement has increased on the part of men. So, that’s just wonderful. I think outcomes for families are much better when men are involved in this way. But the system doesn’t support men to be as involved as they want to be. They don’t get access to the same amount of parental leave that is really supporting them to be as involved as they want to be. So, there’s a strong societal expectation that men are more involved during the perinatal period. But they’re still up against some pretty big hurdles to make it happen.

CLAUDIUS REIMAN: I agree completely with what you said. Because when my son was born, I believe I only had two weeks off from work and the rest of the time I actually had to take as annual leave from my job, and at the time I was working in a winery as the head laboratory technician test all the wine samples and they were about to start vintage. So, I essentially went back to work about a week before vintage started and vintage in a winery is the busiest time in a winery. There are 12 hour shifts, almost completely around the clock. So, I completely understand what you’re saying and I can fully support that.

CAROL DABB: Not all men have the flexibility or the adaptability or even access to annual leave. Not all men have annual leave.

DAN MOSS: Thank you, Claudius. Thank you to our panellists. We’re just running out of time. Carol and Claudius, I’m kind of cutting you off there, I apologise. I could ask you questions for all day I think. This has been such an insightful and fascinating conversation. We look forward to joining you in our next webinar between CFCA and Emerging Minds. But for now, can you please join in thanking me, I’ve just had a wonderful time listening to the expertise and the experiences of Carol, Claudius and Kirsty. Thank you all so much.

CAROL DABB: It’s a pleasure.

CAROL DABB: Thank you.

CAROL DABB: Thanks, Dan.

DAN MOSS: No problem. Thank you.