When mothers suffer from postpartum depression, there are numerous public and private services to help them cope. But men with depressed partners are at greater risk of perinatal depression themselves. And yet new fathers often suffer in silence and obscurity. Even home visitation and partial hospitalization programs that address the unique needs of mothers with mental health challenges often leave their male partners on the sidelines.
Kevin Gruenberg and Richard Cohen, of the Center for Reflective Communities in Los Angeles, hope to change that. With the help of local hospitals, they developed one of the first home visitation programs specifically tailored for fathers, offering mental health services to the partners of women who have been hospitalized for postpartum depression and anxiety. The program puts struggling new dads in touch with mental health experts who can help them learn confidence and coping skills.
“Dads don’t usually start off saying they don’t want to be involved in their kids’ lives, but there are a lot of systems in place that make it hard for dads to be involved,” Gruenberg said. “It’s not fair to say that dads should be involved without providing necessary support.” He spoke with Fatherly about the unique challenges that new fathers face, and how his program is impacting men who otherwise slipped through cracks in the public health system.
How did you get started counseling fathers?
When I went to graduate school to become a psychologist, I was quite geared toward young children and infant mental health—I had a stepdaughter and my wife was pregnant. But then I started to connect the dots. All of the research that I was reading and writing about, it was all about moms and babies. All of the programs that I was learning about, all moms and babies. Dads were left out. That was a real impetus for getting into this field.
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Was there anything out there for struggling dads before you started home visitation work?
Very little. I don’t think there was a program focused on home visiting with dads, working on the father-infant relationship, supporting dads with the challenges of having partners with severe postpartum depression and anxiety. Most home visitation programs will say that they’re very welcoming to dads, but they’re not engaging dads, not really trying to include them. They’re open to dads if they want to participate. We’re really trying to change the culture in these sorts of programs, because both moms and dads are vulnerable to their own perinatal mental health issues. “Welcoming” dads is not enough.
What exactly happens during these home visits with new fathers?
We partner with UCLA’s perinatal partial hospitalization program. When they have moms in that program [with postpartum depression] they refer the dads to us. We also work with Providence Saint John’s Health Center. That’s usually how our conversations start with dads.
The home visits can really range based on the needs of the dad. Some sessions we’re on the floor with the dads, playing with the baby, helping dads figure out what the baby might be thinking or feeling. We use that as an entry point into building their relationship because, when you’re able to read what someone is saying underneath their behavior, you’re able to connect to them in a different way. Other sessions might be about how difficult their relationship with their partner is right now, or how anxiety has gotten in the way of the dad interacting with the baby.
One dad who was quite skilled in connecting with his baby felt no self-confidence. His wife’s anxiety was through the roof, so she was concerned about everything that was going on with the baby and he questioned himself a lot—could he be a good dad? In this case, our job was showing him that he had a really robust capacity to connect with his baby. Sometimes we would record video of him interacting with the baby, and then watch the videos together. He was often surprised at how well the baby is doing, or how well he was doing as a father.
Have you experienced any pushback from dads who feel they don’t need your help?
They say that they’re actually pretty confident and that they’re doing well with the baby. I tell them that I’m open to helping them wherever they’re at, or being useful in whatever way they feel would be useful. I remind them that having a wife with postpartum depression puts them at risk for depression, and I acknowledge that this probably isn’t what they expected after having a baby and that having a wife or partner in the hospital can be really stressful and confusing. Generally, dads who questioned whether the program would be valuable had a lot to say, once we showed curiosity and openness to hearing about what they were experiencing.
What has your work taught you about fathers and fatherhood?
Dads don’t usually start off saying they don’t want to be involved in their kids’ lives, but there are a lot of systems in place that make it hard for dads to be involved, and it’s not fair to say that dads should be involved without providing necessary support. Dads need a lot more support than they’re getting. They need more mental health services, more father-specific parenting services. They need to be included in everything from doctor visits to childhood mental health services to things happening at school. Dads are capable of exposing their children to the world, nurturing them, and loving them. They have a deep capacity and desire to connect with their babies. One of the challenges is that they don’t always know how to make that connection.