Paternal perinatal mental health support: fathers’ perspectives on barriers, facilitators, and preferences

Abstract

The perinatal period is a time of increased vulnerability to psychological distress. Paternal mental wellbeing is linked to both maternal and child wellbeing. Paternal mental health problems are common in the perinatal period. Men, however, report a lack of therapeutic support. This study focused on the experiences of fathers with poor mental health during the perinatal period, who had a biological child under the age of two and a half, and explored their perceptions of barriers and facilitators to, and preferred sources of, mental health support. Semi-structured interviews were undertaken with eight participants and an experiential thematic analysis conducted. Three main themes were identified; “Fathers are not the priority (sub-themes of “Deprioritised”, “Masculinity”), “The perinatal period is unique” (sub-themes of “Needing to be prepared”, “Stretched resources”, “Disconnection from partner”) and “Dad specific support” (sub-themes of “Someone to speak to”, “Actively offered”). These themes identified barriers of exclusion by, and lack of information from, services, prioritisation of the mother and baby, stigma, masculine norms, and emotional, financial, and time pressure. Facilitators identified included healthcare professionals focusing on the father’s mental health and providing signposting, and fathers receiving support from their partner. Participants valued opportunities for greater social connection but their preferred mental health provision was one-to-one, personalised support that was actively offered and targeted specifically at fathers. This study highlights the universal need for greater awareness of paternal mental health in the perinatal services and the necessity for accessible, appropriate, and timely support.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44192-025-00165-x.

The perinatal period, defined as the time during pregnancy to the first year after the birth of a child, is characterised by change for both parents [1]. Role confusion [2], fatigue [3], adjustments in routines, relationships, and roles [4], social isolation, societal pressure [5], and financial or work tensions [6, 7] may negatively impact parents’ mental health [8, 9]. Indeed, the birth of a child can impact both parents’ wellbeing [10], yet paternal mental health is a neglected area of the literature [11, 12].

Estimating the prevalence of paternal perinatal mental health problems is challenging due to a lack of routine screening [13], an absence of validated screening tools [14], and no formal, universally recognised definitions [15]. There are multiple paternal mental health disorders which may be present perinatally [11] however research focuses primarily on depression and anxiety [15]. Studies report that paternal perinatal depression is experienced by 8% of fathers [16], although prevalence rates as high as 26% have been reported 3- to 6-months postnatally [17]. Anxiety disorders are less well researched [11] but are pervasive [18] with studies finding up to 51% of fathers experience anxiety disorders during the postnatal period [19]. There is also a link between paternal and maternal postnatal depression [9, 20], and paternal depression increases the risk of relationship disharmony [21]. Anxiety negatively impacts social relationships [19], and both paternal perinatal depression and anxiety can negatively impact parenting [19, 22, 23], and children’s development [24, 25] and wellbeing [26–29].

Despite the high prevalence and long-term consequences of paternal mental health disorders in the perinatal period, fathers report inadequate support [1, 30, 31]. In order to effectively tackle these issues, more research is needed into the barriers to, and facilitators of, accessible and effective services [32–34]. Factors which can act as barriers may be numerous and interacting. For example, institutional barriers are reported to exist within services designed with an emphasis on maternal and child health and wellbeing [35], with both practitioners and fathers focusing on the needs of mothers and children [33, 36]. Fathers report that communication with health professionals in maternity services is poor [37], and they describe feeling unacknowledged and excluded [1, 30, 38], with a lack of signposting or education [39]. Additionally, masculine ideals of independence, wariness of stigma or cultural insensitivity, and employment patterns can all act as additional barriers within the perinatal period [40–44].

Additionally, men may require different forms of services than women in order to facilitate seeking mental health support [45]. For example, internet sources may be a preferred option during the perinatal period [40, 46], though it has also been reported that first-time fathers prefer personalised, face-to-face support, and improved preparation for the perinatal period [47]. Positive attitudes towards mental health, mental health literacy, and an awareness of services act as facilitators to men accessing mental health services in general [48], however facilitators to men accessing support specifically in the perinatal period are not well studied. Some research indicates that highlighting the importance of the fathering role and raising awareness of the symptoms of poor paternal perinatal mental health may facilitate access to mental health support for fathers [41, 42, 49].

Further qualitative research is needed, focusing specifically on fathers who experienced poor mental health in the perinatal period, who may not have accessed support [41, 42]. Exploring the views of fathers who have experienced mental health problems in the perinatal period in order to identify barriers and facilitators relating to their access to mental health support can inform healthcare professionals’ practice and service planning and provision. Such an aim can be further enhanced by considering what fathers’ preferred forms of mental health support are.

Research question

What do men expecting a biological child, or parenting a biological child under the age of two years and six months old, who have experienced or are experiencing a mental health problem during the perinatal period, view as barriers and facilitators to help-seeking for mental health difficulties in the perinatal period? What are the mental health support preferences of these men in the perinatal period?

Methodology

Methods

Experiential qualitative research was used in order to elicit a rich description of fathers’ perspectives in an under-researched area [12, 50]. Therefore, semi-structured interviews allowed for a detailed, sensitive investigation of individual experience, through flexible exploration and clarification of questions [51]. Experiential thematic analysis identified themes relative to the research question, allowing data to be considered in relation to relevant theories [52].

Procedure

The study was conducted in accordance with British Psychological Society (BPS) guidelines for research ethics [53] and given ethical approval by Glasgow Caledonian University School of Health and Life Sciences Psychology, Social Work and Allied Health Sciences departmental committee on 5th July 2023, approval code HLS/PSWAHS/22/277. Purposive sampling, using opportunistic and snowball strategies, was used to identify fathers who could provide in-depth insights [54]. Participants were recruited via adverts shared on social media. Adverts were also displayed by community groups and services, both via their social media outlets and in hard copies. Semi-structured interviews were audio-recorded and were each approximately thirty-minutes long. Interviews focused on the perinatal period and inquired about: (a) participants’ experience of their mental health (b) the support for their mental health experienced by participants, and their preferred forms of mental health support (c) the barriers and facilitators to accessing mental health support. Additional information is given in a supplementary file (Interview Guide).

Participants

Men were invited to participate if they were expecting a biological child, or had a biological child under the age of two and a half, and had experienced poor mental health in the perinatal period. The research assumes ontological relativism and a subjectivist stance, considering reality as individually constructed [55]. Therefore, poor mental health was defined as either diagnosed or self-identified. The study excluded participants under the age of 18 and fathers of children who entered the family through adoption or fostering due to the specific needs and experiences of these men [56–58].

Although the perinatal period is defined as the time during pregnancy and up to the first year following the birth of a child [59], participants were included if their child was under two years and six months old, to capture parents’ full experience of routine support [60, 61] while remaining close enough to the perinatal period to ensure recent experience [62, 63]. This was important as the negative impacts on health [64], life satisfaction [65], and relationship satisfaction have been shown to endure until at least the pre-school years [66].

Sample characteristics

Eight participants completed interviews. All participants were partnered and employed. Table 1 presents a summary of participant characteristics. All except one participant self-identified as experiencing anxiety and/or depression, while two participants reported experiencing stress. The ages of the fathers’ children ranged from 2 to 60 months and three of the men had two children while the remaining five men had one child.

Table 1.

Characteristics of participants

Participant	Number of children	Ages of children at interview in months	Self-identified description of mental health during perinatal period
1	1	2	Anxiety/depression
2	1	7	Anxiety
3	1	9	Depression
4	1	24	Anxiety/stress
5	1	29	Anxiety
6	2	48 & 7	Anxiety
7	2	48 & 10	Stress
8	2	60 & 24	Depression

^{Participants are referred to numerically to ensure anonymity}

Analysis

Following verbatim transcription, audio recordings were analysed using experiential thematic analysis to identify shared patterns of meaning and experiences [67]. Following familiarisation with the data, prominent aspects were labelled with codes in a data-driven process by FC. Codes were then grouped into related themes or subthemes, named, and reviewed in relation to the full data set to ensure representation of the data. A constant process of reflexivity was undertaken by FC throughout, with SH reviewing themes to ensure methodological rigour [68]. Discrepancies were resolved through discussion until a consensus was agreed. Finally, the themes were interpreted in relation to the research question [52] and supporting quotes are reported in the Results section using pseudonyms to refer to participants in order to maintain anonymity. Interviews generated similar themes indicating data saturation [69].

Results

The three overarching themes identified were: “Fathers are not the priority” (sub-themes of “Deprioritised” and “Masculinity”), “Perinatal period is unique” (sub-themes of “Needing to be prepared”, “Stretched resources”, “Disconnection from partner”) and “Dad specific support” (sub-themes of “Someone to speak to” and “Actively offered”). These themes provided insight into both the barriers and facilitators to mental health support for men in the perinatal period. In addition, fathers’ preferred modes of support were also identified (see Table 2).

Table 2.

Barriers, facilitators, and preferred support identified by participants

Barriers	Exclusion by, and lack of information from services, prioritisation of the mother and baby, stigma, traditional Western masculine norms, emotional, financial, and time pressure, disconnection from partner, introversion, lack of confidence, symptoms of mental health condition, being unable to identify poor mental health
Facilitators	Healthcare professionals welcoming and including fathers and focusing on the father’s mental health, providing antenatal information regarding paternal mental health, and offering signposting information to services. Fathers receiving support from their partner to access services and identify symptoms
Preferred mental health support	One-to-one, personalised emotional support, ideally in person, that is actively offered and targeted specifically at fathers

Theme 1: Fathers are not the priority

This theme captured fathers’ experiences of their partner’s and baby’s needs taking priority during the perinatal period. This acted as a barrier to men receiving support for their mental health.

Subtheme 1: Deprioritised

All participants described missed opportunities for basic paternal mental health support in the perinatal period, such as signposting or psychoeducation. Service structures were designed for mothers only, and services for fathers were experienced as inadequate.

“I think I was just not really, not really thought about” (Neil)

“Maybe there's an opportunity for the NHS as part of that mother and baby care responsibility to just check in on the dad as well” (Calum)

Participants also described feeling invisible or unwelcome at perinatal health appointments. Men who directly approached perinatal and generic support services reported being openly dismissed or told that the service was inappropriate for their needs, leading to additional feelings of isolation and distress.

“While I did go to all the midwife appointments, and while I did go to all the scans it was, it very much felt like I was sat there as the third wheel” (George)

Men in this study minimised their requirements for support. They prioritised the wellbeing of their partner and baby, and other responsibilities.

“My thought process is like, well, mother baby are the priority…I’m not important. Like it’s not about me. It’s about them” (Alan)

“The emphasis would be on me to come forward and to come and use those services rather than at a time when, like, there's all these other things that are going on, it doesn't feel like a priority at the time” (Stuart)

Despite the absence of available support, participants still identified facilitators. Some voiced that antenatal information about the process of pregnancy, caring for a newborn, and accessing support enabled men to feel engaged with services. Similarly, being welcomed and having their presence valued at appointments was a facilitatory factor.

“Our midwife was really good in offering that opportunity to talk kind of as the three of us also kind of signposted away to other kind of local or online services as well” (Calum)

Subtheme 2: Masculinity

Fathers explicitly referenced traditional Western masculine norms as barriers, including stoicism and self-reliance.

“I think the whole thing about men and mental health support is quite hard, as in I think it's, you know, it's not normal in male society” (George)

“It's been very brute force, you know? Take it on the chin and just got on with it sort of thing to be that kind of tactic, which in retrospect has not been the best way to go about it” (Alan)

Other participants alluded to the barrier of male culture within their work, social context, and family origins. Some fathers described active rejection of these norms as a faciliatory factor, and subscribed to a more contemporary stance, valuing expression of vulnerability and requesting help [70]. Nevertheless, these men described continuing to be impacted indirectly by traditional norms, finding that their social network or male-only spaces lacked emotional support.

“I never really approached my dad, or my older brother because I, I knew that the advice there would be very much like well, just, you know, just get on with it or something” (Alan)

“I found it really tricky because naturally, the people I feel more drawn to with all of the mums cause I'd rather, go and speak to them, but the pool of people that I'm like meant to go and speak to are all of the dads” (Stuart)

Theme 2: The perinatal period is unique

The perinatal period appeared to present unique challenges and opportunities for accessing mental health support.

Subtheme 1: Needing to be prepared

Fathers expressed feeling underprepared for the unfamiliar, and at times traumatic experience of the perinatal period. They reported that a lack of awareness of paternal perinatal mental health issues or available support acted as a major barrier to accessing help, and they expressed both a need and a preference for antenatal education.

“First time parents, that nobody knows what they're doing, that's the big barrier” (John)

“Dads could get postnatal depression. I didn't even know that…I just felt like that was kind of how it's supposed to be. I kind of convinced myself like, oh, this is just how it is. It will get better” (Alan)

When participants accessed antenatal information, it was experienced as validating and an empowering facilitator, creating realistic expectations. All participants suggested that information about men’s mental health should be disseminated during pregnancy.

“But for me personally, knowing about things makes me less worried about it than, than not knowing about it” (George)

“I just think it just needs to be part of the signposting process right from when you’re pregnant” (Gary)

Subtheme 2: Stretched resources

Men reported that the perinatal period presented unique barriers to accessing mental health support, including restricted time, financial pressure, and stretched emotional resources. Participants referred to role conflict and strain, and the emotional struggle and stress arising when multiple societal roles have competing demands, as endangering mental health in the perinatal period.

“You don’t really have the chance to kind of look at that stuff this is all, it’s all baby, baby stuff. Trying to be a dad trying to do the best you can. So you don’t really have the opportunity at that point” (Alan)

“I’m gonna have this dual pull of work saying, well, you’ve got to be at work. I am aware it’s a time strain” (George)

“It's just the flexibility, the empathy and the fact that it's not far away, really… I guess for most dads that would also mean it needs to be in hours that work for their jobs” (John).

Subtheme 3: Disconnection from partner

The perinatal period was unique in creating a deficit in social connection. Participants reflected that either their partners were overwhelmed and preoccupied themselves, or that they decided against voicing their own needs to protect their partners.

“I think since, you know, you’ve got all the normal lack of sleep and everything on top of all that, and it’s just then, we’re both just completely unable to really even support, support ourselves or each other” (John)

“…if I was to vocalise my anxieties that would throw her off of her path” (George)

Some men reported that their partners’ experience and support was the strongest facilitator in accessing help, and it was highlighted that the wellbeing of the whole family should be considered.

“I think the support of my wife and sort of her constantly prodding was really helpful” (George)

“It needs to be incorporated as a family thing, rather than just focusing on baby and a little bit of mum” (Gary)

Theme 3: Dad-specific support

Participants reflected that mental health support needs to be directly and explicitly promoted for fathers. Some participants had been offered but declined generic therapy services, again, reiterating the distinctiveness of the perinatal period.

“Making clear that it’s welcoming to dads” (John)

“I needed it to feel like it was for me” (Alan)

Subtheme 1: Someone to speak to

When discussing preferred mental health provision, men acknowledged the challenge of catering to individual needs. Four participants directly named in-person counselling as their preferred mental health support. The other four described the need for an emotionally-supportive relationship with a professional which could provide information and a signposting service, with antenatal access acting as a facilitator.

“Someone in the kind of postnatal service who alongside the sort of health visit thing texting just to kind of see how people were doing mentally and how people were coping and stuff like that would be useful” (Richard)

“The best kind of support for me at that time would have been some counselling” (Alan)

Fathers stressed the importance of social networks, valuing a sense of connection, validation, and shared experience, however differentiated between this as social support, and specific mental health support required when experiencing difficulties such as anxiety or depression. Participants reported lacking having somewhere confidential to discuss their experience of pregnancy and the life changes brought about in the perinatal period.

“There's so much that changes. And that you have to give up. And some people say it's not even giving up, but I felt like I was giving up large parts of who I was” (Gary)

Men described various challenges to accessing group support. These included services being online, geographical isolation, introversion, and lack of confidence, as well as lack of information, expressing a preference for one-to-one support such as counselling.

“I think there's also an assumption that you just, you, you could go and join online at a dad group. But I feel like. But I'm not sure we'd want to talk about the same things” (John)

“So then to me kind of looking at Dads’ support groups, it's almost the complete opposite of where my comfort level is, yeah” (Stuart)

Subtheme 2: Actively offered

Having described the multiple barriers to accessing mental health support in the perinatal period, the participants highlighted the importance of mental health support for men being actively offered as a facilitator. Men reported motivation to attend routine appointments and identified this as an opportunity to engage with expectant fathers.

“You wanna go to all the scans because it’s new and it’s exciting. So sort of capitalising on that of, like, grabbing a dad at that point” (George)

“Something that like where it was brought up to you first, as opposed to us having to ask, I think” (Richard)

“When we had a midwife visits for the baby again, same sort of thing like just a little checking in with Dad. How's dad doing?” (Alan)

“She said we've got this Dads’ group and it might be worth being in it and you know and attending when you can for support. So that was a sort of send an e-mail and get an invite” (George)

Discussion

This study explored fathers’ perceptions of barriers and facilitators to, and preferred mental health support in the perinatal period. The men participating in this study described diverse experiences of poor mental health, at different stages of their parenting, and in varying social contexts. All, however, described inadequate mental health support during the perinatal period.

Deprioritised

Major barriers were reported, as, despite being in regular contact with healthcare professionals, participants described services as designed to support women only. There was a lack of information and support for fathers, who felt ignored and excluded during appointments and the birth itself. Similar institutional barriers have been reported in previous studies [33, 35, 47, 71, 72]. The resulting feelings of marginalisation are commonly experienced by fathers in the perinatal period [49] and this may encourage disengagement from involvement with the baby [73], prevent future help seeking [30], and increase the risk of paternal perinatal depression [74]. Conversely provision of information to men has been shown to lower the risk of paternal postnatal anxiety [75].

These reports contradict midwives’ and health visitors’ descriptions of their practice [76] which should involve working in partnership with both parents and identifying perinatal ill health [77, 78], especially due to the known relationship between maternal and paternal perinatal mental health problems [20]. Effective engagement with fathers may be impacted by these professionals’ lack of time, resources, and training, with record keeping processes and working hours acting as additional barriers [79–81]. This potential organisational bias and wider perception that men’s mental health needs during the perinatal period are unimportant is a recurring finding in the literature [82, 83], and such attitudes may become internalised by fathers [84, 85].

Indeed, prioritising others as a barrier to accessing their own mental health support is found throughout studies of men’s experiences in the perinatal period, with men describing hiding their own poor mental health to protect their partner [72, 86–88]. Nevertheless, previous research echoes the finding that being welcomed and included in appointments acts as a facilitatory factor for fathers [89]. Referring to both parents in antenatal appointments increases inclusion and empowerment [89], which may promote help-seeking [48, 90] and reduce anxiety [91]. Building a relationship between professionals and both parents antenatally would capitalise on men’s early engagement with services, facilitating access to mental health support when routine visits reduce later in the perinatal period, a time when men’s mental health is possibly at greater risk [17].

Perinatal period

Fathers described the perinatal period as unique, and other researchers similarly report that during this time stressors are specific, for example, fears related to previous experience of miscarriage or traumatic childbirth [7, 35]. Research has demonstrated that being unable to recognise symptoms acts as a barrier to support for men in the perinatal period [41]. This is reflected in the wider field, with no universally accepted definitions of paternal perinatal mental health problems and a lack of research [12, 82].

As in previous studies, participants reported lacking having somewhere confidential to discuss their experience of pregnancy and the life changes brought about in the perinatal period [72], however, life transitions can require assistance in processing the losses, challenges, and opportunities presented [92]. The transition to motherhood has gained more interest in recent years [93], however, becoming a parent is a major biopsychosocial life event for all in a caregiving role [94]. Patrescence, the process of becoming a father [95], involves neurobiological changes which may impact on mental health [82]. This multifaceted, culturally situated transition [96] requires much greater understanding [97, 98] to inform service provision and de-stigmatise fathers’ experiences.

This deficit of knowledge has been found in other studies, with men frequently expressing the unmet need for information specifically tailored to fathers [47, 99–101] and appreciating the attendant sense of control and preparation [102–104]. Fathers have reported feeling helpless and excluded when uninformed, contributing to their risk of developing perinatal mental health issues [37] but that preparation can be a preventative measure, increasing feelings of support and satisfaction [88]. In this study, antenatal information regarding mental health was described as empowering and could act as a preventative measure in supporting mental health, as well as facilitate access to services.

Social support

Interpersonal support may be considered essential to successful adaptation during a life transition [105]. Participants highlighted the importance of wider social networks, identifying these as protective factors for mental health [106, 107]. Lack of social support increases risk of paternal perinatal depression [9] and stress in the perinatal period [7]. First-time parents especially express a need for reassurance and social support [71, 100].

Some participants described their partners as acting in a strong facilitative role, and previous research suggests that partners enable fathers’ access to mental health support by identifying symptoms of poor mental health, sharing experiences, and providing encouragement [108]. Partners can act as gateways to information for men in the perinatal period [49], and as facilitators to identifying support needs [109]. This indicates a role for educating mothers on signs of paternal mental health problems [108], especially when symptoms may be gender specific [82, 110].

Conversely, in this study, where women were overwhelmed and preoccupied themselves, fathers noted a reduction in this central support as a barrier to accessing services. Men often rely on their partners as their main source of emotional support [35], creating a potential vulnerability in the perinatal period when relationships are negatively impacted. Couple conflict and marital dissatisfaction are common in the perinatal period [4, 111] and are risk factors in paternal perinatal depression [82, 112]. Maternal and paternal mental health are interrelated [20, 113]. Poor maternal mental health may prevent a father from sharing his own struggles, leading to greater relationship dissatisfaction, and further low mood [9]. This indicates a need for services to consider the wellbeing of the family as a system [114], a perspective shared by fathers [115].

Role strain

Participants noted the barriers of stretched resources between settings such as work and home, including emotional, financial, and time pressures. Resulting role strain and a feeling of being overwhelmed prevented help-seeking. Inflexible working arrangements, and lack of workplace support have been shown to be significant barriers to men to accessing resources and support in the perinatal period [49]. Private therapy can be costly and easily deprioritised as the perinatal period brings financial pressure [116, 117], a risk factor for paternal perinatal depression and anxiety [112]. This highlights the importance of financially accessible, accommodating support [79].

Internal barriers

Men also reported internal barriers including introversion and lack of confidence, and symptoms of the mental health problem itself. Traditional Western masculine norms [118] of restricted emotionality, stoicism, and self-reliance [119] as well as wider barriers of male culture also restricted available emotional support within social networks. Adopting traditional masculine norms has been associated with lower help-seeking and the presence of negative attitudes towards mental health support among men [120], as well as being a risk factor for paternal anxiety and depression [112]. Negative emotions may be perceived as a sign of weakness [121], and failure to conform to masculine stereotypes can lead to self-stigma which perpetuates avoidance of help-seeking [122, 123]. However, barriers to help seeking described are more complex than simply ‘hegemonic masculinity’ [124], and include lack of awareness, shame, distrust, fears around confidentiality, and concrete barriers such as finances, time, and poor service availability which perpetuates negative beliefs around help seeking [122].

Actively offered, ‘Dad-specific’ support

Midwives and health visitors actively enquiring into fathers’ wellbeing was rare but seen as facilitative and valuable. Actively inviting and openly including fathers within conversations which include paternal mental health during flexible, accessible appointments, may therefore act to reduce public- and self-stigma [71, 79, 84].

Participants emphasised the distinctive nature of the perinatal period, requiring mental health support over and above the generic systems that could be routinely accessed. Men reported a preference for accessible, one-to-one, personalised emotional support, ideally in-person, echoing past research [47, 71, 115, 125], however, much greater research is needed into effective therapeutic interventions [126, 127].

Participants in this study identified that services need to be promoted specifically towards fathers and actively offered to overcome barriers. Research has shown that mental health services which use targeted messaging and advertising can facilitate access [128]. Being engaging and responsive to men’s needs acts as a facilitator [48]. This messaging may counteract the barrier of self-stigma [129, 130], especially when marketing is congruent with traditional male gender roles [131], increasing access.

Fathers’ mental health is not routinely screened as mothers’ is in the perinatal period [132]. In order to actively offer services, development of appropriate, acceptable screening tools may be necessary [14, 47, 133], however, current research is limited by issues such as lack of universal diagnoses [82] and underreporting of symptoms [11]. Mental ill health can take many forms [31], and may be missed by fathers, their partners, and healthcare professionals in part because symptoms are atypical in men [8, 134], and coping styles of avoidance, suppression, distraction, and social withdrawal impact on help seeking [135].

Nevertheless, men reported motivation to attend routine appointments, which could provide opportunities for psychoeducation [136] and normalisation around the experience of patrescence, challenging self-stigma and false beliefs [137]. Health professionals therefore taking an active interest in fathers and their wellbeing when opportunities present themselves may act as a facilitator [138]. Additionally, mental health issues may not develop until later in the perinatal period when routine visits from health professionals have reduced, and so raising awareness early in the perinatal process may be a crucial facilitator to later access [139].

Limitations

Using opportunistic and snowball strategies for recruitment may have failed to capture perspectives from difficult-to-reach individuals [140]. Limited demographic information was collected and this may hinder contextualisation of the results. Barriers to, and preferences for, mental health support may vary between cultural groups [141], indicating further research needed to consider factors which may interact with culture, such as organisational bias [142], stigma [143], attitudes towards mental health [144], and experience of patrescence [96]. Advertising in English, predominantly on social media, with initial access required via email may have excluded those who find these aspects a barrier to mental health support. No fathers were recruited in the prenatal period, a time which the participants referred to as requiring specific support.

Conclusion

There is a lack of qualitative research exploring fathers’ experiences of, and negotiation of, poor mental health during the perinatal period. This study identified numerous interacting barriers for men, including exclusion by, and lack of information from services, emotional, financial and time pressures, and disconnection from their partner. Prioritisation of the mother and baby, stigma, masculine norms, introversion, lack of confidence, and symptoms of the mental health condition itself prevented men from seeking help. Access to help was facilitated by fathers being welcomed and openly included in routine appointments, and healthcare professionals and partners focusing on fathers’ mental health. Clearly the interrelated nature of mental health in the perinatal period [20] suggests that families should be conceptualised, and communicated with, as a system. Antenatal information, including actively offered services, was valued. Services could consider written information, signposting to links and resources, and including fathers’ wellbeing within antenatal classes, which could also educate mothers. Fathers reported a preference for accessible, one-to-one, personalised emotional support, ideally in-person. Participants in this study highlighted the need for support to be specifically promoted as for fathers, and actively offered, presenting a new perspective to an under-researched area.

Supplementary Information

Below is the link to the electronic supplementary material.

Author contributions

Both authors contributed to the study conception and design. The data collection, analysis and final write-up was completed by Dr Fern Copland. The study was supervised by Professor Simon Hunter. Both authors read and approved the final manuscript.

Funding

No funds, grants, or other support were received.

Data availability

Anonymised data sets used in this paper are available on request from Dr Fern Copland.

Declarations

Ethics approval and consent to participate

Ethical clearance for this study was gained from the Glasgow Caledonian University School of Health and Life Sciences Psychology, Social Work and Allied Health Sciences departmental committee on 5th July, 2023, approval code HLS/PSWAHS/22/277. Informed consent was obtained from all individual participants included in the study. Participants signed informed consent regarding publishing their data. Anonymised data sets used in this paper are available on request from FC.

Competing interests

The authors declare no competing interests.