Getting creative to engage fathers

This is a post I wrote last September when I had the privilege of visiting the Family Action Centre at the University of Newcastle in NSW, Australia. I’m re-posting today as part of  International Fathers Mental Health Day to help raise awareness of some of the ways we can support fathers during the perinatal period.   […]

This is a post I wrote last September when I had the privilege of visiting the Family Action Centre at the University of Newcastle in NSW, Australia. I’m re-posting today as part of  International Fathers Mental Health Day to help raise awareness of some of the ways we can support fathers during the perinatal period.

Recent reports about ways to get fathers more involved in services around the time of having a baby suggest that shifts in the way services work are needed. This might include more flexible working hours, joint invitations to appointments, or posters and leaflets that are more relevant to fathers. At the Family Action Centre (FAC) within the University of Newcastle, the team researching fatherhood, led by Associate Professor Richard Fletcher, have come up with some different ideas. They believe that the sorts of changes in services will do little to encourage fathers because the spaces in antenatal clinics, perinatal services, and children’s centres are so culturally geared towards women and 20160905_155058infants that men are likely to continue feeling on the outside. Instead, their approach has been to find novel ways of including fathers in the transition to parenthood. Last September I met with the team in their offices on the leafy campus of the university to find out more…

Mobile technology

The SMS4Dads project has just completed a very successful pilot and is looking to expand. This project involves sending regular SMS messages to dads from 6 months into the pregnancy to 3 months after the baby is born. Messages include things about the baby (e.g. although s/he cannot tell you, you are very important to your baby), the relationship with their partner (e.g. some babies are still waking a couple of times a night at 6 months. Being kind to each other can help get through this time), and the man’s own health and well-being (e.g. it’s ok to ask for help. We all need it at some point). In addition to the messages he is asked to complete a ‘mood tracker’ every 3 weeks and if his response is negative this triggers a call from a perinatal support service to check how he’s doing and if he’d like any support. The pilot included 520 men, a huge 87% of whom kept receiving the messages throughout the study (men can opt out at any time), and it has had some good feedback. Men reported that the timing is important – messages relevant to what is happening during the pregnancy and at different stages of infant development help them to understand the process, and they also reported that the messages helped start conversations with their partner about how they’re doing.

The pilot study included anyone who was willing to sign up to the project. There are now plans to target specific groups, for example, men whose partners have mental health difficulties, families where there is alcohol misuse, and aboriginal communities. This is a wonderful way to keep men engaged and involved in the whole process of having a baby and help them reflect on and understand the transition to fatherhood. Further feedback and measurements in the next phase will help the team at FAC to understand the specific things which are helpful about the messages and the ways they might link to better outcomes for families. Richard Fletcher’s team suspect there may be something about relationships at work, whereby the messages are conceived of almost like a therapeutic relationship, with men feeling held in mind and considered as important. If so, the hope is that this would boost self-efficacy when it comes to parenting, encouraging further involvement, and also help parents to communicate better, maintaining a strong relationship throughout all the changes. Some of the messages are written from the point of view of the baby e.g. ‘Just because I’m sucking my hands doesn’t always mean I’m hungry. It might be my way of chilling out’. Therefore they also have the potential to encourage ‘mind-mindedness’ of the infant.  This refers to the ability to think about the mind of the baby and what might be behind different behaviours, and is linked to better outcomes for children.

Clearly there is a lot of potential in this work and it will be interesting to see how the next phases of the project pan out. If successful, perhaps this is something the UK could make use of.

Parenting partnerships

PerinatalThe other key area of research at FAC relevant to engaging fathers is that around parenting partnerships. The support that someone feels from their partner and the strength of the relationship has been linked to a number of outcomes e.g. child behaviour, parenting satisfaction and breastfeeding rates. How can practitioners target this relationship with only the mother in the room? This is something I’ve come across in my own practice, where women talk about relationship difficulties as the key factor affecting their mood, but their partner is unable or unwilling to come into the clinic. This issue is also present in other services such as health visiting where practitioners are used to dealing with women and may actually be reluctant to involve the father, despite the fact he is key to healthy family functioning.

Dr Chris May has developed a tool for health visitors which may help to bring partners into the system without them having to be physically present. This is a card sorting task which health visitors give to families to do in their own time.There is a set of cards for mum, one for dad, and one for the couple. The cards have examples of different worries or concerns that each person may have about different aspects of family life and have to be sorted into those areas which are a high priority for change and those that are medium and low priority. The idea is to stimulate thought and reflection about current circumstances and also encourage a conversation between partners about how they’re doing. The results can then be discussed with the HV to help think about any areas where there may be extra support available. One outcome would therefore be for the HV to have a better understanding of the family’s needs which would lead to more targeted support. However, a more subtle and potentially longer lasting outcome would be to strengthen the communication and support between partners, helping couples to understand each other’s concerns and talk about their views. A pilot of this tool is just about to begin to see if families are willing to complete it and what they think of it. Again, if successful, this is something that could help fathers in the UK to be brought into the thinking and practice around the perinatal period without relying on big changes in the way services function.

20160909_091516

There is a lot more work going on at the FAC which there isn’t space to talk about here, but certainly there is a lot that we can learn from their work about novel ways to encourage a whole family approach, involve fathers, and strengthen the parenting partnership.

Want to know more?

Family Action Centre, University of Newcastle

SMS4dads project

The Marcé Society – crossing boundaries in Perinatal and Infant mental health

Final day at the Marcé conference here in Melbourne. It’s been an amazing few days and the talks today really summed up the way that work in this area crosses so many boundaries – professional, cultural, generational, conceptual and methodological. People from all over the world have attended the conference, from a wide range of professions and with many ideas about what leads to difficulties, the best way to reduce distress and how to develop the evidence base for the work we do.

The day began with the Channi Kumar lecture given by Professor Rhonda Marriott entitled ‘Reflections on culturally secure practice’. Understanding more about the history of Australia and the challenges of providing health services across cultural divides has been a big part of my learning here. The Aborigines and Torres Strait Islanders have different customs, languages and beliefs around health and childbirth, and may live in remote locations with few available health services. Rhonda described how women from these ethnicities have a lower mean age when they give birth, have more children, are more likely to smoke during pregnancy, and are 3 times more likely to die of conditions related to pregnancy and delivery.

20160928_091739

She has been undertaking a project to find out what aboriginal women want around birth, interviewing women and translating this data into policy recommendations and then into practice. She used the phrase, ‘Nothing about us without us’ to highlight the importance of collaborative relationships to develop practice that is culturally secure. She also emphasised the importance of understanding the experiences of past generations of Aboriginal people and what this might mean for parenting and prevention. Given yesterday’s lecture about the intergenerational transmission of trauma, this once again highlighted the need to think not only across cultures but also across generations when understanding what leads to distress.

This year the Marcé medal was awarded to Nine Glangeaud-Freudenthal for her contribution to the Marcé Society. She gave a history of the society, explaining that Louis Victor Marcé was a French doctor who published the first treatise devoted to Postpartum Psychosis and ‘insanity in pregnant women’, as well as describing the prevalence of women’s depression during the perinatal period. She also talked about the first official biennial meeting in 1982, when Channi Kumar was elected president, and gave an overview of the subsequent presidents and meetings. Today the Marcé Society is increasingly international and multidisciplinary, including many regional groups and the contributions of consumers as well as clinicians and researchers. This variety really enriches the conference and the possibility for learning from each other, and is another example of the way the society is crossing boundaries in its work and aims. You can read more about the history of the society here.

Towards the end of the day the final plenary was given by Michael O’Hara who was given the title, ‘Frontiers in treating perinatal depression’. He gave an overview of different treatments and noted that while having an intervention was generally better than having no intervention, there were often no differences in the effectiveness of different treatments. Importantly, his take home message was about the opportunities for improving infant mental health alongside perinatal mental health. Again, this way of thinking across generations is so important to work in this area.

The end of the conference meant saying goodbye to Jeannette Milgrom as president. She was thanked for increasing the regional groups and bringing more people together, as well as for her warm, committed and inclusive leadership style. She handed over the presidency to Jane Fisher who gave an emotional address about the challenges of increasing global recognition of perinatal mental health in a context where the argument for improving mental health outcomes is often about the economic productivity of the population. She set out a passionate and ambitious vision for making a difference, especially with the launch of the Global Alliance for Maternal Mental Health. She spoke specifically about the need to include more Low and Middle Income countries in the society and, in this context, she introduced the next biennial meeting to be held in Bangalore in 2018, hosted by Prabha Chandra.

These talks really brought together the theme of crossing boundaries in our work, which I’ve been so struck by over the last few days. I’ve come away with many new ideas and feeling really inspired by this experience. Time to start saving for Bangalore….

Want to know more?

The Marcé Society

Marcé Day 2!

It’s been another packed day of incredible talks and presentations!

The day opened with the award of the John Cox Medal to Vivette Glover, Professor of Perinatal Psychobiology at Imperial College, London. Vivette gave an overview of current research on the impact of stress during pregnancy, including the way that genes moderate the impact of maternal stress on child outcomes. Specifically, Vivette highlighted how many current studies use Caucasian populations which may not be generalisable. This is an important point, particularly with the launch of the Global Alliance for Maternal Mental Health. Much of the information about Vivette’s work can be found on the website Begin Before Birth.

Professor Rachel Yehuda gave a fascinating plenary on her work on on the intergenerational transmission of trauma. She has done a lot of work with the offspring of holocaust survivors and described how the effects of parental trauma are observed in the next generation. However, she explained that effects can be passed on not only through DNA, but also through changes in utero and differences in postnatal parenting, meaning that there are multiple places for intervention. She used the lovely phrase, ‘Epigenetic mechanisms provide weapons of mass construction’ to summarise how environmental influences can impact development. You can read more about Rachel’s work here.

During the morning session I attended a great symposium on fathers mental health, which included talks on prevalence data, an update about intervention projects, and an initiative looking at health professionals training and competence in this area. Key messages were around the need for multilevel/systemic changes to develop father-inclusive practice i.e. families need to believe father is important and want him involved, professionals need to shift attitudes, services need to change practices, and society more generally needs to understand the importance of fathers in a family’s life so that it becomes normal to include dads across services.

The afternoon plenary included a talk by Professor Ian Jones about severe postpartum mood disorders, providing an update on current research and opportunities for intervention. This was followed by a talk about consumer led organisations in Australia and how important they’ve been in providing support to families as well as raising awareness and providing professional development. Particular focus was given to PANDA (Perinatal Anxiety and Depression in Australia click here for website) who have been key to supporting perinatal developments here in Australia .

20160927_141403

There have been several sessions focused on screening for perinatal mental health disorders. This is a complex and sometimes controversial area, as reflected by the different opinions and ideas presented here at Marcé. An afternoon panel discussion by the authors of the book, ‘Identifying Perinatal Depression and Anxiety: Evidence-based practice in screening, psychosocial assessment and management’, brought up many of the key issues, including the need for effective tools, the importance of training and support for those doing the screening, and of course how essential it is to have adequate care pathways and treatments for those who screen positively. Another symposium looked at women’s experiences of being screened for mental health disorders, how valid and reliable current screening tools are, and ways to screen for disorders other than depression.

The day ended with the Gala dinner, decorated with images from the huge range of different countries represented at Marcé. We were also treated to an introduction to the next conference to be held in Bangalore in 2018 with a performance of Indian dancing.

Want to know more?

Marcé conference website

Marcé Conference day 1

The International Marcé Society Biennial Conference is being held in Melbourne this year. It brings together professionals from all over the world from both research and clinical backgrounds who are working in Perinatal and Infant Mental Health. It’s an opportunity to share learning and expertise, to update about the current evidence base and best practice, and to meet face to face those who are influencing the field and driving change.

The conference opened with an introduction by the President of the Marcé Society, Professor Jeannette Milgrom, who paid respect to the land we are on and to elders past and present. This is to acknowledge the history of the people and place where the conference is being held. Jeannette also highlighted that we are talking about a fundamental human issue and one about families and inter-generational difficulties that can affect anyone from any background.

20160925_173928

The opening talks included an address by the Australian Minister for Health, Sussan Ley, who has been a big supporter for the perinatal mental health initiative and who also spoke about her own family’s experience of PMH. We also heard from Professor Mark Hanson and Professor Louise Howard, both from the UK, who are leading research on the developmental pathways to disease and on the association between domestic violence and mental health respectively.

Following this, the delegates split off into different rooms with the opportunity to hear about research and service developments across a huge range of topics, from psychopharmacological treatments to fathers mental health and methods for national data collection.

The afternoon session began with the launch of the Global Alliance for Maternal Mental Health (GAMMH) by Dr Alain Gregoire. Alain has been instrumental in leading changes in the UK through the Maternal Mental Health Alliance, and now called for an international alliance to lead change globally. He spoke about the health disparities across different countries and the need to work together to improve access to specialist services for all families.

The afternoon symposiums also covered a wide range of topics, from developments in Mother Baby Units, to the role of GPs and lessons from maternal suicides. Following this packed programme, delegates could attend dinners hosted by some of the keynote speakers, watch the BBC documentary ‘My baby, psychosis and me’, or just go and explore the bars and restaurants of Melbourne.

Similarly to the previous Marcé conference in Swansea in 2014, the overwhelming impression from the day has been of the enormous passion and dedication of people working in this field. Despite barriers, challenges and frustrations, the determination of professionals to provide high quality, accessible services for families in need continues to inspire and impress.

Want to know more?

Marcé conference website

 

Getting the basics right

Sometimes in my clinical work I see women who have enjoyed their pregnancy and have no history of mental health difficulties. But once the baby arrives they become highly distressed. The very basics of early parenting – feeding and sleeping – prove impossible to get right. The baby won’t settle, or is not putting on enough weight, or cries incessantly. The mother is trying everything, reading everything, sleep deprived and increasingly frantic about her seeming inability to get these fundamentals sorted. She often believes she is ‘failing’ as a mother and that everyone else seems to be managing. Not surprisingly, these experiences often lead to thoughts that they have made a mistake and should not have had a child. This leads to guilt and shame for thinking those things. Women may also disclose thoughts that the baby is somehow doing it on purpose to persecute them, or that the baby must hate them – not a useful frame of mind in these early months. And of course the more distressed they become, the harder it is to settle the baby, leading to a vicious circle that is very difficult to get out of.

What do we offer these parents in the UK? The woman’s health visitor can visit at home and offer advice about sleeping and feeding based on best practice, encouraging different strategies and helping to identify where things are going wrong. In addition, the individual therapy that I may offer gives a safe space to talk about what’s happening, notice some of the unhelpful thinking patterns and support new ways of understanding what’s going on. In some places parents may attend groups or workshops to get advice and support. But at 3 o’clock in the morning when the baby has been crying for hours and refuses to feed, when parents haven’t slept for days and are feeling trapped and desperate, these interventions may have limited effect.

At the Ellen Barron Family Centre (EBFC) in Brisbane, Australia, they provide something different.

The EBFC is a short-term residential program for families who require support with building practical skills and confidence in parenting from 0-3 years. Parents stay for 4-5 days, or 10 days for families with more complex difficulties, and are given a family room with a nursery attached. They have an allocated nurse to provide individualised guidance for their needs and 24 hour support. The model of care focuses on sleep and settling, breastfeeding and feeding, child behaviour and development, and general parenting skills.

The centre has a multidisciplinary team of nurses, paediatricians, psychologists, and social workers.  They provide a range of groups and sessions during the day, including mindfulness, adjusting to parenthood and more general sessions about sleeping, feeding and play. The messages given are careful to provide choices for the parent, rather than dictating a particular method. However, they are all geared towards supporting parents to notice and respond to infant cues, building the relationship between infant and parent and providing the building blocks for the development of secure attachment.

ebfc2

Both mothers and fathers can be admitted to the program and the rooms have double beds to encourage whole family participation. A father-only group is run one evening a week for those fathers who are working during the days and the staff encourage both parents to take on the messages of the centre so that learning can be maintained after discharge.

There are a number of reasons why parents may come to stay at EBFC. In some families there may be underlying physical health issues which mean that the baby is not reaching developmental milestones or struggles with certain aspects of care. This can be highly stressful for parents. In other cases the difficulties are behavioural and the family has got into patterns which are unhelpful and need extra support to get out of. In other cases, mental health problems or histories of trauma in the parents make it hard to provide consistent care for the infant and support is needed to find ways through this and ensure the early environment for the baby promotes healthy development.

A stay at the EBFC is therefore not classed as a mental health intervention and in fact they describe the centre as a ‘well’ centre i.e. if the child or parent is very unwell, this is not the place for them. The aim is to support the development of the attachment relationship between parents and infants, and is therefore an early intervention that can help to prevent the development of serious PIMH issues later on. In this way, parents with mental health problems are not excluded per se, but need to have the cognitive capacity to take on the messages and learning of the centre. Many families will also have input from other adult and child services alongside their stay and will have a case manager within these other services. The residential stay is therefore usually part of a package of care for struggling families.

Staff at the centre also provide training and support to child health nurses in the community, helping to ensure consistent messages about best practice following discharge and build confidence in the workforce to support parents.

This is a unique service, even within Australia. Referrals may come from the whole of Queensland and even beyond. This is a huge area to cover and means a long trip for families to access the service. But it is highly appreciated by patients and referrers. The support offered means families have a way to pause, focus and reset.

The staff are open about the fact that their system isn’t right for everyone. Families have different needs at different times, and the structure and hospital environment of EBFC may not work for all families. However, a stay at EBFC has been transformational for many families, helping them find new patterns and methods for caring for their babies with the support of a caring, friendly and encouraging team.

This is a preventative model, intervening early in the life of the family to build parenting confidence and help create the foundations for healthy relationships. I’m not aware of anything like this in the UK. Could we benefit from something similar? It may seem like an expensive intervention to provide residential care in this way. However, given the £8.1 billion estimated costs of perinatal mental health difficulties in the UK, 70% of which are borne by the impact on the infant, the investment could be worth it.

Want to know more?

Ellen Barron Family Centre

What’s Queensland doing differently?

It’s been an amazing couple of weeks in Queensland. I’ve had the chance to visit lots of services, as well as meeting with many health professionals around the state and finding out about how they manage to provide services for a population spread over 1.8 million square kilometres (nearly seven times bigger than the UK). This really is an enormous task. There are many remote communities, places where the staff turnover is high and the nearest birthing hospital is a full day’s travel away.

Despite these challenges there are some incredible services being delivered for parents and their infants. Many of these services are linked in to and supported by the Queensland Centre for Perinatal and Infant Mental Health (QCPIMH), a statewide hub of expertise in this area. The centre is based in a cottage on a residential street in North Brisbane and from the outside looks a lot like a nursery or children’s centre. However, inside, the centre is providing something unique to Queensland residents.

20160913_084522

On one side of the building QCPIMH has a clinical unit which provides a 0-4 years infant mental health service. This is a small multidisciplinary team who provide assessment and treatment for struggling families where the infant’s mental health is compromised. This might be because parents have their own mental health difficulties, making it hard for them to respond to the baby’s needs, or sometimes because they had bad experiences of being parented themselves and so don’t have a good model of parenting to draw on. The service is similar to 0-5 CAMHS (child and adolescent mental health) services in the UK, where staff have specialist training and knowledge in infant development and attachment, and work to improve early relationships which are such an important foundation for healthy child development. However, there are few of these around and at the moment only 1% of the CAMHS budget in the UK is spent on under 2s.

On the other side of the building QCPIMH have something a little different going on. Alongside the clinical unit, they have a Strategy and Service Development Unit. This is a statewide service providing leadership, consultation and support to perinatal and infant mental health services across the whole of Queensland. The unit employs two Service Development Leaders, both clinicians themselves, whose aims are to achieve change in four priority areas: service development and implementation, workforce development, mental health promotion and prevention, and evaluation and research.

What this translates to is a whole range of different functions, including providing centralised leadership across different sectors involved in the perinatal period; supporting a focus on the emotional well-being of the whole family within primary care and the non-government sector; consulting on and leading PIMH service development and implementation across sectors; delivering training and education for workforce development; and contributing to the evidence-base for cost-effective best practice by conducting evaluation and research activities. As well as this, staff at QCPIMH are members of a range of mental health networks and committees across the state where they promote and advocate for the needs of infants and families during the perinatal period.

This part of the centre provides a focal point for strategic and service development within this specialist area, ensuring that services are family centred, culturally sensitive and evidence-based. They are helping to establish comprehensive and sustainable perinatal and infant mental health services at a range of levels across Queensland which reflect the needs of local communities. This is a big task and the centre is continuing to expand and develop in order to try and meet the growing need for their expertise. They are about to complete their new strategic plan for the next 5 years as well as launching a new website, and hope to employ more staff to support the current team going forward.

Having this kind of centre, funded by the health service, seems to give some real momentum and focus to the service developments in this area. Staff can help to ensure better integration and communication across different services and have a statewide overview of gaps and areas of best practice. It’s been wonderful observing their work over the last week, learning how they overcome challenges and drive changes in this enormously important area.

Want to know more?

QCPIMH website

Infant mental health developments in the UK

 

Getting creative to engage fathers

This is a post I wrote last September when I had the privilege of visiting the Family Action Centre at the University of Newcastle in NSW, Australia. I’m re-posting today as part of  International Fathers Mental Health Day to help raise awareness of some of the ways we can support fathers during the perinatal period.

 

Recent reports about ways to get fathers more involved in services around the time of having a baby suggest that shifts in the way services work are needed. This might include more flexible working hours, joint invitations to appointments, or posters and leaflets that are more relevant to fathers. At the Family Action Centre (FAC) within the University of Newcastle, the team researching fatherhood, led by Associate Professor Richard Fletcher, have come up with some different ideas. They believe that the sorts of changes in services will do little to encourage fathers because the spaces in antenatal clinics, perinatal services, and children’s centres are so culturally geared towards women and 20160905_155058infants that men are likely to continue feeling on the outside. Instead, their approach has been to find novel ways of including fathers in the transition to parenthood. Last September I met with the team in their offices on the leafy campus of the university to find out more…

Mobile technology

The SMS4Dads project has just completed a very successful pilot and is looking to expand. This project involves sending regular SMS messages to dads from 6 months into the pregnancy to 3 months after the baby is born. Messages include things about the baby (e.g. although s/he cannot tell you, you are very important to your baby), the relationship with their partner (e.g. some babies are still waking a couple of times a night at 6 months. Being kind to each other can help get through this time), and the man’s own health and well-being (e.g. it’s ok to ask for help. We all need it at some point). In addition to the messages he is asked to complete a ‘mood tracker’ every 3 weeks and if his response is negative this triggers a call from a perinatal support service to check how he’s doing and if he’d like any support. The pilot included 520 men, a huge 87% of whom kept receiving the messages throughout the study (men can opt out at any time), and it has had some good feedback. Men reported that the timing is important – messages relevant to what is happening during the pregnancy and at different stages of infant development help them to understand the process, and they also reported that the messages helped start conversations with their partner about how they’re doing.

The pilot study included anyone who was willing to sign up to the project. There are now plans to target specific groups, for example, men whose partners have mental health difficulties, families where there is alcohol misuse, and aboriginal communities. This is a wonderful way to keep men engaged and involved in the whole process of having a baby and help them reflect on and understand the transition to fatherhood. Further feedback and measurements in the next phase will help the team at FAC to understand the specific things which are helpful about the messages and the ways they might link to better outcomes for families. Richard Fletcher’s team suspect there may be something about relationships at work, whereby the messages are conceived of almost like a therapeutic relationship, with men feeling held in mind and considered as important. If so, the hope is that this would boost self-efficacy when it comes to parenting, encouraging further involvement, and also help parents to communicate better, maintaining a strong relationship throughout all the changes. Some of the messages are written from the point of view of the baby e.g. ‘Just because I’m sucking my hands doesn’t always mean I’m hungry. It might be my way of chilling out’. Therefore they also have the potential to encourage ‘mind-mindedness’ of the infant.  This refers to the ability to think about the mind of the baby and what might be behind different behaviours, and is linked to better outcomes for children.

Clearly there is a lot of potential in this work and it will be interesting to see how the next phases of the project pan out. If successful, perhaps this is something the UK could make use of.

Parenting partnerships

PerinatalThe other key area of research at FAC relevant to engaging fathers is that around parenting partnerships. The support that someone feels from their partner and the strength of the relationship has been linked to a number of outcomes e.g. child behaviour, parenting satisfaction and breastfeeding rates. How can practitioners target this relationship with only the mother in the room? This is something I’ve come across in my own practice, where women talk about relationship difficulties as the key factor affecting their mood, but their partner is unable or unwilling to come into the clinic. This issue is also present in other services such as health visiting where practitioners are used to dealing with women and may actually be reluctant to involve the father, despite the fact he is key to healthy family functioning.

Dr Chris May has developed a tool for health visitors which may help to bring partners into the system without them having to be physically present. This is a card sorting task which health visitors give to families to do in their own time.There is a set of cards for mum, one for dad, and one for the couple. The cards have examples of different worries or concerns that each person may have about different aspects of family life and have to be sorted into those areas which are a high priority for change and those that are medium and low priority. The idea is to stimulate thought and reflection about current circumstances and also encourage a conversation between partners about how they’re doing. The results can then be discussed with the HV to help think about any areas where there may be extra support available. One outcome would therefore be for the HV to have a better understanding of the family’s needs which would lead to more targeted support. However, a more subtle and potentially longer lasting outcome would be to strengthen the communication and support between partners, helping couples to understand each other’s concerns and talk about their views. A pilot of this tool is just about to begin to see if families are willing to complete it and what they think of it. Again, if successful, this is something that could help fathers in the UK to be brought into the thinking and practice around the perinatal period without relying on big changes in the way services function.

20160909_091516

There is a lot more work going on at the FAC which there isn’t space to talk about here, but certainly there is a lot that we can learn from their work about novel ways to encourage a whole family approach, involve fathers, and strengthen the parenting partnership.

Want to know more?

Family Action Centre, University of Newcastle

SMS4dads project