Let’s Talk About Mental Health

Printer Friendly, PDF & Email
Publication Date
April 13, 2015

I recently joined my colleagues Frank Blaney and Bridgid Conn, along with Joe Jones from the Center for Urban Families and Tiffaney Parkman from the University of Baltimore, in an NRFC webinar discussion about fathers and mental health.

Research shows that one in five adult Americans will experience a mental health problem this year, but only 38 percent are likely to get treatment. The Adverse Childhood Experiences (ACE) Study demonstrated that most people have experienced some traumatic stressors during childhood, which can have long-lasting negative effects on physical and mental health throughout adulthood.

However, many men are reluctant to talk about emotional distress and, while men are less likely than women to access health care services in general, this is especially true for mental health services (MHS). Why is this and what can fatherhood programs do to help?

Men tend to “suck it up” in line with stereotypical gender expectations that lead them to fear being viewed as “weak” or “crazy.” Not addressing mental health needs, particularly more severe ones, can be very detrimental. The pressure of providing for their families can leave fathers especially vulnerable to depression or anxiety. Further, those struggling with financial difficulties, homelessness, incarceration, or other similar stressors are at higher risk for poor mental health.

What can fatherhood programs do?
Fatherhood programs can play a key role in encouraging fathers to talk about mental health issues and promoting their overall emotional health. By creating “safe spaces” within individual case management meetings, workshops, and peer support groups, fatherhood programs can help men acknowledge, identify, and experiment with disclosing emotional distress.  For some fathers, this level of support is sufficient. However, others may demonstrate more serious mental health needs warranting clinical attention that is often beyond the scope of support a typical fatherhood program is equipped to provide.

In such instances, fatherhood programs can find themselves in quite a predicament. On the one hand, encouraging fathers’ disclosures within “safe spaces” established within the program helps to combat stigma and access care. Yet, on the other hand, when clinical issues are disclosed, programs are often at a loss for appropriate next steps. Staff may lack training around screening for or responding to mental health issues and may require assistance providing linkage to clinical support that is sensitive to the unique needs of fathers.

Providing services
Ideally, program budgets should include specific line items for MHS services. Although that may not always be possible, the advantage would be that programs could use the funds to facilitate seamless access to mental health care for fathers. Perhaps a more realistic first step is to look for ways to create community partnerships, much as fatherhood programs have done with child support agencies and domestic violence prevention programs. Such partnerships could involve cross training of staff to increase awareness of fatherhood staff and sensitivity of mental health professionals; on-site crisis support; and consultation to improve assessment procedures. In some cases, as we do at Children’s Hospital Los Angeles, there might also be opportunities for clinicians to observe or co-facilitate peer support groups. In our program, fathers have the opportunity to engage with clinicians in informal ways. Even something as simple as saying hello in the waiting room helps demystify and destigmatize MHS such that fathers are more open to possible referrals. 

This kind of relationship-building is encouraged and possible for all program staff irrespective of mental health support. Staff can attend community-based meetings, trainings, and conferences to network with community partners. Programs can participate in joint trainings or events to deepen understanding of each other’s approaches to care and create opportunities for dialogue between agencies regarding barriers and unique program-specific needs.

Trauma-Informed Care
Given the high prevalence of trauma among urban fathers, another option is for fatherhood programs to move towards adopting trauma-informed principles as standard operating procedure. Taking a trauma-informed approach reduces stigma to mental health issues by acknowledging on a fundamental level that trauma is a common part of the human experience. It shifts health care provision away from a “what’s wrong with you?” approach to “what’s happened to you?”. This leads to client interactions that are empathic, strengths-based, and more culturally sensitive.

Also, by understanding that men experience a different level and kind of shame related to their experience of trauma, an important element of trauma-informed care includes ensuring that programs are designing and delivering gender-specific services. Lastly, trauma-informed care should include and prioritize support for staff around the emotional stress of working with high-need populations.

Understanding fathers’ emotional experiences and enhancing access to mental health care are complex issues that must be addressed on many levels. While there is no easy solution, continuing dialogue around these barriers is imperative to mental health support for fathers.

Sophie de Figueiredo, Psy.D. , Clinical Psychologist, Children's Hospital Los Angeles, Division of Adolescent and Young Adult Medicine, Project NATEEN

Resources from the NRFC