1. A stay on a psychiatric ward wasn’t part of the plan!
Hang on:
A stay on a psychiatric ward wasn’t part of the plan!
Dr Anna Wroblewska
Consultant Clinical Psychologist
Lothian Perinatal Mental Health Service
MMHS18

2. Maternal Mental Illness
4 stages in recovery.
Recognising the problem.
Seeking and accepting help.
Achieving recovery.
Maintaining recovery.
Family involvement aids all of these stages.
Proximity of the baby is central in achieving and maintaining recovery.

3. Research and recognition is gathering momentum.
Fathers?
Research and recognition is gathering momentum.
Transition to fatherhood involves helplessness, uncertainty and separation.
Fathers have different experiences and therefore different needs.
Because mothers seek support first and foremost from there partner his wellbeing is integral to the whole family unit and so should be explored.

4. Fathers?
What do we know so far?
Fathers make a positive contribution towards recovery especially if he is seen as and described as ‘supportive’.
Studies identify 42-50% of fathers meet the diagnostic criteria for psychiatric disorder at the same time.
Research is beginning in the MBU setting. (Marrs, Reid)

5. Keeping the family together and bonding (Marrs et al 2014)
Aims:
Impact of admission on role and relationships in the family.
Qualitative semi structured interviews.
8 participants.
Grounded theory.

6. Managing the self and other relationships
Bonding with the baby
Keeping the family together
Feeling overwhelmed
Experiencing and managing uncertainty
Feeling contained

7. Bonding with the baby Bonding with the baby Father needing to bond
Feeling left out
Making time for siblings to bond
A fleeting figure
Importance of mother being with the baby

8. Keeping the family together
Trying to be normal
Adjusting to the couple relationship
Relying on support from family and friends
Relationships under pressure

9. Feeling contained Feeling contained Relief of admission holding care
Appreciating expertise
Welcoming but not quite home
Mixed emotions on discharge

10. Feeling overwhelmed Feeling overwhelmed
Experiencing anxiety and stress
Feeling watched
Travel and work pressures
Life turned upside down

11. Experiencing and managing uncertainty
Taking each day as it comes
Understanding illness
Communicating with staff
Understanding treatment

12. Clinical implications
Fathers experience uncertainty and anxiety.
To enable fathers to optimally support their partner it is essential fathers develop an understanding of the illness, treatment and what he can do to facilitate recovery.
Recognition of what hinders communication with fathers.
Attachment style.
Personality.
Confidence in talking to professionals.
Increase communication between professionals and fathers.
Inclusion in meetings, one to one’s, hard copy information.

13. Experiences of Fathers at the Mother and Baby Unit (Reid et al 2016)
Aims:
His experience and its impact upon relationships.
His view of MBU services.
His experience of the involvement of Child and family services.
One to one semi structured interviews.
17 fathers.
Thematic analysis.

14. Theme 1: The Double whammy
Coming to terms with mother’s illness
Coming to terms with fatherhood

15. Theme 2: Understanding the admission and Illness
Partners change
Information
Future expectations of family life and recovery

16. Theme 3: Support for fathers
Partner and baby
Family and friends
MBU
Children and family services.

17. Theme 4: Personal Stressors and coping
Work/life balance
Own health and self care
Other children

18. Conclusions
Overlaps in the themes identified by both studies.
The experience of the father.
Simultaneous challenges of illness, baby, giving and receiving support, work and roles.
Overall the care of the MBU is viewed as positive.
Knowledge, understanding and communication could be improved
How do you best tailor support for the father and from whom?

19. Information for fathers. Regular information sharing and updates.
Implications
Information for fathers.
Regular information sharing and updates.
Suitable interventions.
Psychosocial support for fathers.
What would be best in an MBU setting?
What would be best in a community team setting?
How can we best engage fathers?
What are the barriers and facilitators?

20. Thank you!