By Richard Miller (Independent Policy Contributor)
11 August 2025
Despite an all-too-brief campaign several years ago, paternal Postnatal Depression (PND) remains underappreciated and misunderstood.
The stakes are high: PND has been shown to increase suicide risk in new fathers, and make it more likely that children develop behavioural and emotional disorders. Despite this, the NHS is offering too little information to parents and key frontline staff.
What is PND?
Pregnancy and baby charity Tommy’s defines postnatal depression as when parents ‘have feelings of sadness, hopelessness, guilt or self-blame most of the time for weeks or months’ after having a baby. It’s distinct from the ‘baby blues’, which is far more common and usually confined to the first two weeks of a newborn’s life.
Risk factors for PND include changes in hormones and routine, and the stress of caring for a newborn. One study showed greater prevalence of the condition in countries with higher infant mortality rates, suggesting that poverty is a likely causal link.
Many challenges that new parents face are unique to mothers – not least the physical acts of carrying and giving birth to babies. That said, fathers face their own unique difficulties and must not be forgotten. They require specific provision which, at present, isn’t being signposted to them.
What are the similarities and differences between paternal and maternal PND?
There are some surprising similarities – hormonal changes, for instance. These are well-acknowledged in new mothers, but new fathers can experience them as well, and research suggests that, as with mothers, this could be a biological risk factor for paternal PND.
There are key differences, too. Withdrawal from contact with others is common in those with PND. With fathers, however, this may specifically involve ‘distracting’ behaviours such as over-involvement in work, hobbies, the internet/gaming, and gambling, as is common in male depression more generally. These behaviours could also represent tactics to delay seeking help. And although the NHS lists sadness and low mood as symptoms, men may instead present with outbursts of anger and aggression, and turn to alcohol and drug abuse.
Perhaps the most significant difference is the period during which onset is most likely to occur – key information for health professionals diagnosing the condition. For mothers, typical onset is within the first month of a baby’s arrival. For fathers, research has shown that PND has the highest prevalence within 3 to 6 months after birth.
What do health bodies say about paternal PND specifically?
Not nearly enough. Whilst the NHS website acknowledges that PND ‘can also affect fathers and partners’, most of the information provided is catered to mothers alone, with very little reference to fathers. At present, those who might be concerned about paternal PND are being presented with a confusing picture.
There are problems with internal messaging, too. Although NICE makes clear in its guidance to mental health professionals that PND can occur ‘within 12 months of childbirth’, they also specifically draw attention to the period ‘in the first few weeks after childbirth’, which doesn’t take into account the research pointing to later onset for fathers.
NICE recommends that GPs undertake postnatal checks on women’s physical and psychological health and wellbeing 6 to 8 weeks after giving birth (though even these haven’t always been adequately met), but recommends no mental health checks for new fathers/non-birthing parents.
Health visits, which are key for ascertaining the wellbeing of newborns and parents, are also falling short. The current set appointments for 1 to 2 and 6 to 8 weeks following birth tie in with the periods in which baby blues and maternal PND typically occur, likely by design. After this, however, there aren’t any further mandatory visits until the 9 to 12-month mark, omitting the key 3 to 6-month period when fathers might most need intervention.
This lack of recognition extends beyond the UK, and efforts to raise awareness need to be much more widespread. WHO’s International Classification of Diseases describes PND only as a condition affecting new mothers, and many studies note that there is a lack of established diagnostic criteria for PND in men. This can mean that criteria developed for mothers are applied uniformly, and therefore potentially incorrectly.
Why does this matter?
As Dr Claire Wolstenholme pointed out in her June commentary, men are, in general, already reluctant to identify and seek help for mental health issues. That the NHS barely references a condition which affects similar numbers of new fathers as it does new mothers[1] demonstrates well Dr Wolstenholme’s prognosis of ‘female-oriented mental health support’.
New fathers are currently at risk of missed diagnoses, and thus a lack of appropriate care. Research from Brazil showing that fathers with PND were twenty times more likely to be at risk of suicide than those without any mood disorder makes for sobering reading, and demonstrates just how important this issue is.
Mothers and children are affected, too. Recent research noted that depressive symptoms in fathers can, in turn, negatively impact mothers’ mental health, and that paternal PND ‘may result in behavioural and emotional disorders in children such as depression, anxiety and language development delays’. An Australian study made similar observations, and another found that this disruption to children’s development is greater when both parents are depressed than when only one is.
There is some good news: talking therapy services are already prioritising new and expecting parents, and do not discriminate between mothers and fathers – but without better guidance, many new fathers who could benefit from this provision won’t be signposted to it.
As Dr Wolstenholme notes in her commentary: ‘men are willing to talk about their mental health’ in ‘the right circumstances and environment’. We should make every possible effort to help them do that.
Policy proposals
As the government produces its forthcoming Men’s Health Strategy for England, it should strongly consider the issues raised in this commentary.
The NHS website should be updated, making uniformly clear that postnatal depression can also affect fathers and partners, with guidance amended to reflect the differences in symptoms and typical onset of the condition. In addition, NICE should consider existing research on paternal PND and ensure that information for GPs, Health Visitors, and any other relevant front-facing staff is up-to-date and accurate.
Health Visitors should consider offering an additional set appointment to families with newborns sometime around the 3 to 6-month period, ensuring that fathers are seen at the point they’re most likely to present with PND. The government should make funding available to enable this.
The forthcoming ‘Best Start’ family hubs aim to support children in the most disadvantaged areas of the UK. Given the likely link between PND and poverty, staff at hubs should be given training in identifying PND in fathers and mothers alike. Staff should also be given training in how to tackle mental health stigma in men, and authorised to directly refer new patients to talking therapies services in order to minimise the risk of disengagement.
Paternal PND remains an under-researched condition, and much of the existing research has been carried out in countries other than the UK. The NHS and other health bodies should consider carrying out further research so that PND in fathers can be better understood, and those at risk better supported.
[1] The NHS notes that PND affects more than 1-in-10 women within a year of giving birth; Tommy’s states that ‘PND is thought to affect as many as one in 10 men’.