Strong fathers, strong families: How to beat depression

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There has been considerable attention given to postnatal depression and its impact upon the health of mothers and babies.  Less attention has been given to the effect of depression in fathers. However, research evidence suggests depressed fathers adversely impact upon family health to a similar degree to maternal depression (1,2,3).

Depression in fathers is a major health problem

A recent meta-analysis estimated depression in fathers impacted upon one in ten families (1). As with depression in mothers, the adverse effects included poorer outcomes in children across a range of areas (2).

Depression in fathers was also associated with adverse financial and emotional outcomes for the entire family (2). As with maternal depression, depressed fathers reported poorer engagement with their children (3).

How can we help depressed fathers?

Employment and education help fight depression in fathers.

Employment has been shown to protect fathers from depression. Having a job is a stabilising force, and provides meaning to the father’s life as the person who brings home a family income (3,4,5). Employment is most protective against depression in disadvantaged families. The vicious cycle of  unemployment and unrecognised or untreated depression results in fathers distancing themselves from children (3,4,5). High levels of stress, aggravation and violence can occur (3,4,5).

Education can also protect fathers from depression, especially in families facing socioeconomic disadvantage (6,7).

Helping teenage fathers

We recently explored whether employment and education to a vulnerable group of fathers would reduce depression.

We selected fathers in the setting of a maternal teenage pregnancy as our target group.

We already knew depression was particularly common in teenage fathers (8,9,10,11,12). However, most studies had come from regions where employment and educational opportunities are poor.

What would happen if we could help these vulnerable fathers engage in employment or education. Would the same levels of depression be seen?

The answer is no!

Findings from the Australian Father’s Study

When we assessed depression in teenage fathers in Western Melbourne, we found the same high rates of depression reported elsewhere in the world (13). Western Melbourne has poor opportunities for employment and education for teenage fathers.

In contrast, when we evaluated rates of depression in fathers in the setting of teenage pregnancy in northern Perth, where educational and employment opportunities were greater, we found rates of depression similar to those for other older fathers (14).

If you would like to read our full paper please click here.

So it appears that vulnerable groups of fathers who are able to secure employment or further education, are likely to experience lower rates of depression.

Social determinants of health

Our findings, and those of others, reinforce how important social factors are to the health of families (16). Higher rates of many diseases are found in areas of social disadvantage. The link with depression in fathers is a strong and obvious association, but many other more subtle associations exist.

As medical diagnostic and therapeutic intervention costs rise well above the rate of inflation each year, it pays to reflect on how strengthening the economy, enabling people to find work, and implementing public health approaches may represent better value for money to achieve healthy families.

References

  1. Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression; A meta-analysis. Journal of the American Medical Association 2010; 303: 1961-1969
  2. Ramchandani P, Stein A, Evans J, O’Connor TG; ALSPAC Study Team. Paternal depression in the post- natal period and child development: a prospective population study. Lancet 2005; 3: 2201- 2205.
  3. Bronte-Tinkew J, Moore KA, Matthews G, Carrano J. Symptoms of major depression in a sample of fathers of infants; Sociodemographic correlates and links to father involvement. Journal of Family Issues 2007; 28: 61-99.
  4. Dooley D, Prause J, Ham-Rowbottom KA. Underemployment and depression: longitudinal relationships. Journal of Health and Social Behaviour 2000; 41: 421-436.
  5. Taris TW, Bok IA, Calje DG. On the relation between job characteristics and depression: A longitudinal study. International Journal of Stress Management 1998; 5: 157-167
  6. Alio AP, Mbah AK, Grunsten RA, Salihu HM. Teenage pregnancy and the influence of paternal involvement on fetal outcomes. Journal of Pediatric and Adolescent Gynecology 2011; 24: 404-409.
  7. Holden GW, Nelson PB, Velasquez J, Ritchie KL. Cognitive, psychosocial, and reported sexual behavior differences between pregnant and non-pregnant adolescents. Journal of Adolescence 1993; 28: 557-72.
  8. Bauldry S. Variation in the protective effect of higher education against depression. Journal of Society and Mental Health 2015; 5: 145-161.
  9. Jeffery T, Luo K, Kueh B, Petersen RW, Quinlivan JA. Australian Father’s Study: What influences paternal engagement with antenatal care? The Journal of Perinatal Education 2015; 24(3):181-187(7)
  10. Quinlivan JA, Tan LH. Domestic violence, single parenthood, and fathers in the setting of teenage pregnancy. Journal of Adolescent Health 2006; 38:201-7.
  11. Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology 2003; 157: 98-112.
  12. Taylor DJ, Chavez GF, Adams EJ, Chabra A, Shah RS. Demographic characteristics in adult paternity for first births to adolescents under 15 years of age. Journal of Adolescent Health 1999; 24:251-258.
  13. Quinlivan J, Condon J. Anxiety and depression in fathers in teenage pregnancy. Australian and New Zealand Journal of Psychiatry 2005; 39: 915-920.
  14. Atkinson AG, Petersen RW, Quinlivan JA. Employment may protect fathers in the setting of maternal teenage pregnancy from anxiety and depression: Findings from the Australian Father’s Study. Repro System Sexual Disorders. 2016 5:1 http://dx.doi.org/10.4172/2161-038X.1000161
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