Postnatal depression among fathers is a ‘real and significant public health issue', however it is not widely acknowledged and there is little research in this area.

According to University College Cork lecturer (UCC), Lloyd Philpott, while there has been a growing awareness about the burden of ill-health among men in recent decades, paternal postnatal depression (PPND) is one condition that receives little attention.

"In general, the mental health of fathers in the postnatal period is often not considered. This has resulted in men being underscreened, underdiagnosed and undertreated for PPND and other postnatal mental health problems," he noted.

While estimates vary, a review of 43 studies found that PPND affects up to 10% of new fathers worldwide. However, Mr Philpott pointed out that the real prevalence may be higher as men ‘are reluctant to report mental health problems'.

One of the most common risk factors for PPND is maternal postnatal depression. In other words, if the mother is depressed, the risk of the father becoming depressed is higher.

A lack of social support also increases the risk of PPND, particularly among men who belong to non-traditional families. An unplanned pregnancy, or a lack of choice and preparation, also appears to increase the risk.

Men with lower levels of education are also at greater risk. This appears to be because less educated fathers have more difficulty in obtaining information about PPND and access to services they may need.

While symptoms of postnatal depression among women include low/sad mood, anxiety, lack of interest, reduced self-esteem, poor sleep and difficulty coping, PPND manifests differently in men. Symptoms can include hostility, anger and conflict.

As a result, while women may internalise their problems, men may externalise through coercive and aggressive behavior. Depressed fathers may also display less positive behaviours such as responsiveness and sensitivity.

Mr Philpott pointed out that there is no evidence that screening for PPND takes place. Furthermore, there is no specific screening tool or official set of diagnostic criteria for PPND.

He noted that as PPND is closely related to the mental health of a man's partner and the health of their relationship, ‘the most effective support for men comes from their partner'.

"Support from society, such as paid paternity leave, also helps fathers adapt to changes during the postpartum period. Paternity leave has been identified as one of the few policy tools available to governments to directly influence behaviour among fathers," Mr Philpott said.

He pointed out that healthcare professionals also need to be educated in this area so that they can better identify and manage PPND.

"There is also a need to educate and advise fathers and their partners in relation to the signs and symptoms of PPND," he added.

Mr Philpott is a lecturer in UCC's School of Nursing and Midwifery. He wrote about this issue in WIN (World of Irish Nursing & Midwifery), the journal of the Irish Nurses and Midwives Organisation.