The Critical Role of Home Visiting in Recognizing and Addressing Paternal Depression

After my nearly 20 years in the home visiting field, many success stories stand out for me. One story centers on a depressed father who discovered joy in parenting. The home visitor noticed that the father rarely made eye contact and seemed completely disengaged. The mother shared that he also rarely interacted with her or their son. With his permission, the home visitor identified a counselor to provide the father with in-home therapy. After a few sessions, the father’s affect changed completely. He began participating in the home visits, playing with his son, and helping the mother with his care. Imagine the difference this made in his child’s life!

According to the American Academy of Pediatrics, up to 25% of fathers experience depression during their partner’s pregnancy or the year following birth. When the mother is also depressed, this number can increase to 50%. Studies also show that a child’s development is significantly impacted, in both the short and long term, when both parents are depressed.

There is growing recognition of the need to screen mothers for perinatal depression and to ensure they receive the necessary services. However, what is rarely acknowledged is the impact of a father’s depression on both the quality of the parent-child interaction and his relationship with the other parent.

Here are some steps the home visiting field can take:

• Routinely screen fathers and other male caregivers. The Edinburgh Postnatal Depression Scale, a screening tool commonly used for mothers, has been validated for men. It could easily be administered during home visits and/or visits to the medical provider.
• Recognize the symptoms of depression in fathers. Most people don’t know that fathers’ hormones also change during the pregnancy, which can impact their mood. Men who are depressed may appear angry, withdrawn, or irritable, and they may not find pleasure in activities they used to enjoy.
• Understand that addressing depression is the first step in father engagement. The field of home visiting has been working diligently to increase father engagement, but there is a missed opportunity if home visitors fail to recognize and address the mental health issues that may stand in the way.

Depressed fathers are at increased risk of substance misuse and intimate partner violence. Over the past year, these risks have been exacerbated by the isolation and related stressors of the pandemic. But it doesn’t have to be that way. With education, fathers could be routinely screened and referred for treatment. If implemented, this practice will go a long way toward supporting the family’s future and optimizing child outcomes.

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Allison Parish directs the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Technical Assistance Resource Center at EDC. She is endorsed in infant mental health policy and is an early childhood advocate.